What is chorioamnionitis?
Chorioamnionitis may be a bacterial infection that happens before or during labor. The name refers to the membranes surrounding the fetus: the “chorion” (outer membrane) and the “amnion” (fluid-filled sac).
The condition occurs when bacteria infect the chorion, amnion, and amnionic fluid round the fetus. It can cause a preterm birth or serious infection within the mother and therefore the baby. It’s most commonly seen in preterm births; it’s also seen in approximately 2 to 4 percent of full-term deliveries.
Chorioamnionitis is additionally referred to as “amnionitis” or “intra-amniotic infection.”
What causes it?
This condition usually develops because of an infection that can occur when bacteria that are normally present in the vagina ascend into the uterus, where the fetus is located.
E. coli, B streptococci, and anaerobic bacteria are the foremost common causes of chorioamnionitis. The amnionic fluid and placenta — and baby — can become infected.
What are the symptoms?
Chorioamnionitis doesn’t always cause symptoms, but some women may experience:
Ø rapid heartbeat
Ø uterine tenderness
Ø discolored, foul-smelling amniotic fluid
What are the risk factors?
The most common risk factors for this condition include:
Ø young maternal age (less than 21 years old)
Ø low socioeconomic status
Ø first pregnancy
Ø long labor
Ø membranes that are ruptured (water has broken) for an extended period of time
Ø premature birth
Ø multiple vaginal examinations during labor (only a risk factor in women with ruptured membranes)
Ø pre-existing infections of the lower genital tract
Ø internal fetal or uterine monitoring
If you've got one or more of those risk factors, you'll be more likely to develop chorioamnionitis.
What are the complications?
Chorioamnionitis is usually considered a medical emergency. The condition can lead to serious complications, including:
Ø bacteremia (infection in the bloodstream)
Ø endometritis (infection in the lining of the uterus)
Ø need for cesarean delivery
Ø heavy blood loss with delivery
Ø blood clots in the lungs and pelvis
About 3 to 12 percent of girls with chorioamnionitis have bacteremia. This condition also increases the need for a cesarean delivery. Of those who have a cesarean delivery, up to 8 percent develop a wound infection and approximately 1 percent develop a pelvic abscess (collection of pus). Maternal death due to infection is extremely rare.
Babies delivered to mothers with chorioamnionitis also are in peril of great complications:
Ø The condition can lead to meningitis (an infection of the lining of the brain and spinal cord). However, this occurs in less than 1 percent of infants who are delivered to term.
Ø Pneumonia or bacteremia may also develop in about 5 to 10 percent of babies born to women with chorioamnionitis. Bacteremia is more common in preterm infants.
In rare cases, the complications related to chorioamnionitis are often life-threatening to preterm infants. These complications are less likely to occur if the infection is diagnosed early and antibiotic treatment is started.
How can it be prevented?
Your doctor will make every effort to prevent the infection from developing in the first place.
Ø screening you for bacterial vaginosis (vaginal inflammation) in your second trimester
Ø screening you for group B streptococcal infection once you reach 35 to 37 weeks of pregnancy
Ø reducing the number of vaginal examinations performed during labor
Ø minimizing the frequency of internal monitoring
It’s important to attend regular checkups with your doctor and address your questions and concerns.
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