Chorioamnionitis
(Amnionitis; Chorioamnion Infection; Intra-amniotic Infection)
Definition
| Birthing Complications: Intrauterine (Uterine) Infection |
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| Copyright © Nucleus Medical Media, Inc. |
Causes
Risk Factors
- Young age
- Low socioeconomic status
- First child
- Multiple vaginal exams after rupture of the amniotic sac
- History of bacterial infection, such as group B streptococcus (GBS) and bacterial vaginosis
- Premature rupture of membranes —your water breaks before you go into active labor
- Long labor
- A previous baby born before 37 weeks
Symptoms
- Fever
- Increased heart rate in both the mother and the fetus
- Tender uterus
- Discharge with odor from the vagina
- Maternal leukocytosis—an increased number of white blood cells in the mother’s blood
- Bacteria, white cells, and low amounts of glucose in amniotic fluid as determined by amniocentesis
Diagnosis
- Your bodily fluid may need to be tested. This can be done with:
- Blood tests
- Amniocentesis
Treatment
Delivery
- Vaginal delivery would take too long
- Mother shows signs of worsening illness
- Baby shows signs of distress
Antibiotics
- For the mother—Antibiotics will be delivered directly into the mother's veins by IV. Antibiotics will be continued until the mother is without a fever for 48 hours.
- For the baby—After delivery, the baby will be monitored for infection. If needed, antibiotics will be given.
Prevention
- Attend regular prenatal check-ups. Call your doctor if you have any questions or concerns.
- Get tested for GBS. This routine vaginal culture is done during your 35th-37th week.
- Take steps to prevent bacterial vaginosis. For example, practice safe sex. Do not use douches or feminine sprays.
- Tell your doctor right away if you have premature rupture of the membranes —water breaking before labor starts.
RESOURCES
American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients
American Pregnancy Association http://americanpregnancy.org
CANADIAN RESOURCES
Health Canada http://www.hc-sc.gc.ca
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
References
Alanen A. Polymerase chain reaction in the detection of microbes in amniotic fluid. Ann Med . 1998;30:288-295.
Bacterial vaginosis (BV). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 25, 2012. Accessed March 12, 2013.
Bacterial vaginosis—CDC fact sheet. Centers for Disease Control website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm . Updated September 1, 2010. Accessed March 12, 2013.
Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. MMWR . 2002;51:13-15.
Chorioamnionitis. Cleveland Clinic Health Information Center website. Available at: http://www.clevelandclinic.org/health/health-info/docs/3800/3857.asp?index=12309 . Accessed March 12, 2013.
Churgay CA, Smith MA, Blok B. Maternal fever during labor—what does it mean? J Am Board Fam Pract . 1994;7:14-24.
Edwards RK. Chorioamnionitis and labor. Obstet Gynecol Clin North Am . 2005;32:287-296.
Eschenback D, Gravett M, Willoughby R. Infectious diseases, preterm delivery, and infant outcomes. Emerg Infect Dis November 2004.
Gabbe S, Niebyl J, Simpson JL, eds. Normal and Problem Pregnancies . 4th ed. Oxford, UK: Churchill Livingstone, Inc.; 2002.
Greenwald J. Premature rupture of the membranes: diagnostic and management strategies. Am Fam Physician August 1993.
Protect your baby from group B strep. Centers for Disease Control website. Available at: http://www.cdc.gov/groupBstrep/prevention%5Fspot/ . Updated September 18, 2012. Accessed March 12, 2013.
Use of prophylactic antibiotics in labor and delivery. The American Congress of Obstetricians and Gynecologists, Practice Bulletin No. 120 . June 2011.
Wellbery C. Neonate CBC and maternal chorioamnionitis. Am Fam Physician March 2005.