Chorioamnionitis

Overview

Chorioamnionitis describes inflammation of the placental membranes (the chorion and amnion) and tissues connected to it, including foetal blood vessels and the umbilical cord, due to intrauterine ascending infections from the vagina or cervix.

It is a medical emergency and can be life-threatening to both the mother and foetus.

Risk Factors

The major risk factor is the preterm premature rupture of membranes, which can expose the uterus to potential infections.

Presentation

Features of chorioamnionitis include:

• In the mother:
  • Fever, tachycardia
  • Purulent vaginal discharge/amniotic fluid 
  • Uterine tenderness
• In the neonate:
  • Foetal tachycardia may be seen

Some cases may be asymptomatic.

Management

Chorioamnionitis is often diagnosed clinically in the intrapartum period. It is managed with prompt delivery (including via caesarean section) and intravenous antibiotics. If foetal distress develops, an emergency delivery is indicated.

Complications

Neonatal complications include prematurity, cerebral palsy, retinopathy of prematurity, bronchopulmonary dysplasia, respiratory distress syndrome, and neonatal sepsis.

Maternal complications include pelvic infections, preterm delivery, postpartum haemorrhage, and sepsis.

Prognosis

• Most women recover and do not require further antibiotics after delivery