Chorioamnionitis

Chorioamnionitis

Chorioamnionitis is an infection of membranes and amniotic fluid among pregnant women which may cause premature delivery and other complications to both the mother and baby. ^[1]

Epidemiology

In underdeveloped nations, the condition is greatly linked with preterm birth which is then associated with a high death rate. ^[2] Around 2 % of births in the United States are associated with chorioamnionitis. ^[4]

Causes

There are a lot of ways by which a pregnant woman can get the disease since the infection can start anywhere including the vagina and the rectum. Among these are thru vaginal examinations and during prolonged labor. ^[3] Abnormal bacterial colonization and urinary tract infections incurred during pregnancy are also suggested in the pathophysiology of chorioamnionitis. ^[2] Common organisms that are associated with chorioamnionitis include Escherichia coli (E. coli) and Group B streptococcus. ^[1]

Signs and Symptoms

A person with chorioamnionitis may not have any symptom. In some, fever greater than 37.8 degrees Celsius and painful uterus are present. Some have purulent and malodorous amniotic fluid or vaginal discharge. Increased heart rate of both the mother and the fetus may also be recorded. Additional findings that may be suggestive of chorioamnionitis include cool or clammy skin and significant decrease in blood pressure or hypotension. ^{[1] [2]}

Diagnosis

After a thorough medical history taking and physical examination, a patient is often asked to undergo laboratory exams to verify the presence of infection. Blood tests may be done. Sample of amniotic fluid from the mother is also often obtained in order to check for the presence of pathogens that cause chorioamnionitis. ^[4]

Treatment

Management depends upon the circumstances. When there is acute chorioamnionitis that causes severe distress to the fetus, delivery is done immediately. Antibiotics are given which is usually prescribed until after delivery. Pre-term babies have increased chances of developing pneumonia, meningitis and respiratory complications. Proper medical intervention should be given and transfer to an appropriate neonatal intensive care unit (NICU) should be done without delay. Full term babies are less likely to have complications. ^{[1] [2]}

 

References:

1.       http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02441

2.       http://emedicine.medscape.com/article/973237-overview#a0199

3.      http://www.babymed.com/complications/chorioamnionitis

4.      http://my.clevelandclinic.org/healthy_living/pregnancy/hic_chorioamnionitis.aspx

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