Chorioamnionitis: Symptoms, Causes, Treatment

What are the symptoms of chorioamnionitis?

Chorioamnionitis is an infection of the placental tissues and amniotic fluid, usually caused by bacteria ascending from the vagina and cervix into the uterus. It typically occurs during labor and delivery but can also happen before labor. Symptoms of chorioamnionitis can vary but often include:

1. Fever
2. Increased heart rate in the mother and/or baby
3. Uterine tenderness
4. Foul-smelling amniotic fluid
5. Cloudy or yellow amniotic fluid
6. Maternal leukocytosis (increased white blood cell count)
7. Maternal tachycardia (increased heart rate)
8. Fetal tachycardia (increased heart rate in the baby)
9. Abdominal pain
10. Malaise (general feeling of being unwell)

It’s important to note that chorioamnionitis can lead to serious complications for both the mother and the baby if not promptly diagnosed and treated. If you suspect you may have chorioamnionitis, it’s crucial to seek medical attention immediately.

What are the causes of chorioamnionitis?

Chorioamnionitis is usually caused by bacteria that enter the uterus from the vagina and cervix. The most common bacteria associated with chorioamnionitis are:

1. Escherichia coli (E. coli): This bacterium is commonly found in the digestive tract and can be transferred to the vagina and then to the uterus.
2. Group B Streptococcus (GBS): GBS is a type of bacteria that is commonly found in the vagina and rectum of healthy women. It can sometimes cause infections in newborns if passed from the mother during childbirth.
3. Other bacteria: Other bacteria, such as Klebsiella, Enterococcus, and Streptococcus viridans, can also cause chorioamnionitis.

Risk factors for chorioamnionitis include:

• Prolonged labor
• Premature rupture of membranes (when the amniotic sac breaks before labor begins)
• Multiple vaginal exams during labor
• Internal monitoring of the baby’s heart rate
• Use of a fetal scalp electrode
• Use of certain medical procedures during labor, such as an artificial rupture of membranes or episiotomy
• Infection elsewhere in the body that spreads to the uterus, such as a urinary tract infection

It’s important for pregnant women to attend all prenatal appointments and discuss any concerns or symptoms with their healthcare provider to help prevent and detect chorioamnionitis early.

What is the treatment for chorioamnionitis?

The treatment for chorioamnionitis typically involves antibiotics to treat the infection and may also include supportive measures for the mother and baby. Here’s a general outline of the treatment approach:

1. Antibiotics: Broad-spectrum antibiotics are usually given intravenously to the mother to treat the infection. The specific antibiotics chosen may vary based on local antibiotic resistance patterns and the severity of the infection.
2. Supportive care for the mother: This may include measures to manage fever and pain, such as acetaminophen (paracetamol), as well as intravenous fluids to maintain hydration.
3. Supportive care for the baby: Monitoring of the baby’s heart rate and other vital signs is important. In severe cases, early delivery may be necessary to prevent complications for the baby.
4. Delivery: In cases where the infection is severe or not responding to treatment, delivery of the baby may be necessary, even if it’s preterm.
5. Monitoring: Close monitoring of the mother and baby during and after treatment is important to ensure that the infection is resolving and that there are no further complications.

It’s essential for pregnant women to seek prompt medical attention if they experience symptoms of chorioamnionitis, as early diagnosis and treatment can help prevent serious complications for both the mother and the baby.

Can a baby survive chorioamnionitis?

Yes, a baby can survive chorioamnionitis with prompt diagnosis and appropriate treatment. However, chorioamnionitis can lead to serious complications for the baby, especially if it is not treated promptly or if the infection is severe. These complications can include:

1. Preterm birth: Chorioamnionitis is a common cause of preterm labor and delivery, which can increase the risk of complications for the baby.
2. Neonatal sepsis: Chorioamnionitis can lead to the baby developing a serious infection known as neonatal sepsis, which can be life-threatening if not treated promptly with antibiotics.
3. Respiratory distress syndrome (RDS): Babies born prematurely as a result of chorioamnionitis are at increased risk of developing RDS, a condition in which the baby’s lungs are not fully developed and cannot provide enough oxygen to the body.
4. Long-term complications: In some cases, chorioamnionitis can lead to long-term complications for the baby, such as cerebral palsy, developmental delays, and vision or hearing problems.

It’s important for pregnant women to seek early prenatal care and to notify their healthcare provider if they experience any symptoms of chorioamnionitis, as early diagnosis and treatment can help improve the outcome for both the mother and the baby.