(Amnionitis; Chorioamnion Infection; Intra-amniotic Infection)
Chorioamnionitis is a bacterial infection. It occurs in the membranes that surround the fetus. These membranes are called the chorion and the amnion. It is also an infection of the amniotic fluid. This fluid surrounds the fetus and protects it.
This can be a very serious condition. It requires special care from your doctor. A pregnant woman will need to deliver her baby immediately. This is for the welfare of both the mother and the baby.
Birthing Complications: Intrauterine (Uterine) Infection
Bacterial infections causes this condition. Infection may begin in the mother’s genital tract. Bacteria then moves up to the fetal membranes. It then moves into the amniotic sac and its fluid. There it can then pass to the fetus. Many types of bacteria may cause this infection.
The following factors increase your chance of developing chorioamnionitis:
- 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) or ]]>bacterial vaginosis]]>
- ]]>Premature rupture of membranes]]> (PROM)—your water breaks before you go into active labor
- Long labor
- A previous baby born before 37 weeks
Some symptoms include the following:
- Increased heart rate in both the mother and the fetus
- A tender uterus
- Smelly discharge 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 (determined by amniocentesis)
The infection is diagnosed by the symptoms. Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may also include the following:
- Blood tests from the mother. These are done to check her blood cell count and to check for infection.
- Amniocentesis]]> —a needle is inserted through the mother’s abdomen. A sample of the amniotic fluid is drawn out. The fluid is examined for bacteria, inflammatory cells and glucose levels.
Antibiotics should begin as soon as an infection is found. It may be held off if the mother is about to deliver her baby.
The baby will need to be delivered. A cesarean section]]> (c-section) may be needed if:
- A vaginal delivery would take too long.
- If the mother shows signs of becoming more ill.
- The baby shows signs of distress.
For the Mother
The antibiotics will be given. They will be delivered directly into a vein by IV. Antibiotics may include a combination of:
For the Baby
After delivery, the baby will be watched for infection. They will be looked after by specialists. A neonatologists only works with newborns. The baby may receive antibiotics. The baby will also be observed for 48 hours.
To help reduce your chances of developing chorioamnionitis, take the following steps:
Attend regular prenatal check-ups:
- Contact your doctor if you have any questions or concerns.
Get tested for GBS infection:
- This is done during your 35th-37th week.
- If you have GBS, you will need to receive antibiotics during labor and delivery.
- Tell your doctor if you are allergic to any antibiotics.
Prevent bacterial vaginosis (BV):
- Don’t have sex.
- Limit the number of sexual partners.
- Do not douche. Douching is also associated with BV.
American College of Obstetricians and Gynecologists
Infections and Pregnancy: National Library of Medicine
The Society of Obstetricians and Gynaecologists of Canada
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Bacterial vaginosis fact sheet. Centers for Disease Control website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm . Accessed August 15, 2005.
Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. MMWR . 2002;51(No. RR-11):13-15.
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Gabbe S, Niebyl J, Simpson JL, eds. Normal and Problem Pregnancies . 4th ed. Oxford, UK: Churchill Livingstone, Inc.; 2002.
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Group B strep infection. March of Dimes website. Available at: http://marchofdimes.com/professionals/681_1205.asp . Accessed August 14, 2005.
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Wellbery C. Neonate CBC and Maternal Chorioamnionitis. Am Fam Physician [serial on the Internet]. 2005 Mar.
Last reviewed January 2009 by ]]>Ganson Purcell Jr., MD, FACOG, FACPE]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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