Chorioamnionitis

Definition - What does Chorioamnionitis mean?

Chorioamnionitis is an infection of the membranes (called amnion and chorion) surrounding the fetus caused by bacterial invasion before or during labor. These bacteria infect the chorion (outer membrane), amnion (the inner fluid-filled bag), and the amniotic fluid (fluid around the fetus). The condition can result in premature delivery, and in severe cases, can lead to a miscarriage. Chorioamnionitis is more common in premature infants born before 34 weeks of pregnancy.

FertilitySmarts explains Chorioamnionitis

Chorioamnionitis occurs when the protective barriers of the reproductive tract and/or uterus become compromised during pregnancy or when highly harmful bacteria ascend from the vagina into the uterus. These bacteria can cross and infect the fetal membranes, amniotic fluid, fetus, as well as the placenta.

A combination of one or more the following factors tend to increase the risk of chorioamnionitis:

  • Preterm babies
  • Prolonged rupture of fetal membranes (break down of the water bag takes longer than usual)
  • Premature break down of fetal membranes (before a woman goes into labor)
  • Unhygienic vaginal practices
  • Pre-existing infections of the reproductive tract
  • Bad oral hygiene can influence the composition of bacteria in the vagina so that the bad bugs exceed the number of friendly vaginal bacteria like lactobacilli
  • Short cervix: It’s easier for harmful bacteria to ascend a short cervix
  • Male babies
  • Several vaginal examinations during labor

Women with chorioamnionitis may experience:

  • High-grade fever
  • Rapid heartbeat (>120 beats per minute)
  • Uterine tenderness (pain by touching the uterus)
  • Pus-filled or foul-smelling amniotic fluid or vaginal discharge
  • Premature labor or, even more commonly, preterm premature rupture of membranes (PPROM), which is a break down of the water bag before the normal 37 weeks of pregnancy when a woman would normally go into labor

If the woman is in preterm labor, the doctor may remove some amniotic fluid for assessment. Chorioamnionitis is suspected by the presence of low content of glucose (sugar) and a high number of white blood cells and bacteria in the amniotic fluid.

In chorioamnionitis, the mother and her baby are at risk of life-threatening complications:

  • Bacteremia (infection spreads to the bloodstream)
  • Neonatal sepsis (widespread infection that can damage multiple organs if not addressed appropriately)
  • Endometritis (infection of the lining of the uterus) which can interfere with a woman's potential of getting pregnant in later life
  • An urgent need for cesarean delivery that can result in baby being delivery before the expected period
  • Heavy vaginal bleeding during delivery
  • Development of blood clots in the lungs and pelvis
  • If severe and untreated, miscarriage or fetal death may occur

Chorioamnionitis is usually treated with antibiotics. Depending on the severity, it may be necessary to transfer the delivered baby to a neonatal ICU.

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