Chorioamnionitis

Last revised by Dr Jeremy Jones on 20 Sep 2021

Chorioamnionitis refers to infection of the chorion and amnion during pregnancy.

Chorioamnionitis affects an estimated 2-4% of term deliveries and 40-70% of preterm deliveries1.

Clinically, chorioamnionitis can present with the following maternal signs and symptoms:1,2

  • fever
  • abdominal pain / uterine tenderness
  • raised white blood cell count (> 15 000 cells/mm3)
  • purulent or foul vaginal discharge
  • tachycardia

Chorioamnionitis most frequently occurs due to ascending bacterial infection from the lower genital tract (vagina and cervix) in the setting of prolonged rupture of membranes (PROM)1. Other less common causes include the introduction of infection through invasive procedures such as amniocentesis and chorionic villus sampling1,2.

Immediate initiation of intrapartum broad-spectrum antibiotics greatly reduces adverse maternal and fetal outcomes from chorioamnionitis1.

Differentials that may be considered in the setting of maternal fever and/or abdominal pain include:2

  • pyelonephritis
  • appendicitis
  • pneumonia
  • epidural associated fever (in women with epidurals)
  • thrombophlebitis
  • neonatal sepsis1
  • increased risk of cerebral palsy3

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