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Chorioamnionitis
En Español (Spanish Version)

Definition
Chorioamnionitis is an 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.

Chorioamnionitis can be a very serious condition. It requires special care from the doctor. A pregnant woman will need to deliver her baby right away. This is for the health of both the mother and the baby.

Birthing Complications: Intrauterine (Uterine) Infection

Copyright © Nucleus Medical Media, Inc.

Causes
Bacterial infections usually cause this condition. Infection may begin in the mother’s genital tract. Bacteria then move up from the vagina, through the cervix, and into 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.

Risk Factors
Factors that can increase your chance of developing chorioamnionitis include:

Symptoms
Some symptoms include:

  • Fever
  • Increased heart rate in both the mother and the fetus
  • Tender uterus
  • Discharge with odor 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 as determined by amniocentesis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.

  • Your bodily fluid may need to be tested. This can be done with:
  • Blood tests
  • Amniocentesis
The fetal heart rate will be monitored. The heart rate will increase if the mother has an infection.

Treatment
Antibiotics should begin as soon as an infection is diagnosed. The doctor may wait to give antibiotics if the mother is going to deliver the baby right away.

Delivery
The baby will need to be delivered. A cesarean section (C-section) may be needed if:

  • Vaginal delivery would take too long
  • Mother shows signs of worsening illness
  • Baby shows signs of distress
Antibiotics
  • For the mother—Antibiotics will be delivered directly into the mother's veins by IV. Antibiotics will be continued until the mother is without a fever for 48 hours.
  • For the baby—After delivery, the baby will be monitored for infection. If needed, antibiotics will be given.
Prevention
To help reduce your chance of developing chorioamnionitis, take the following steps:

  • Attend regular prenatal check-ups. Call your doctor if you have any questions or concerns.
  • Get tested for GBS. This routine vaginal culture is done during your 35th-37th week.
  • Take steps to prevent bacterial vaginosis. For example, practice safe sex. Do not use douches or feminine sprays.
  • Tell your doctor right away if you have premature rupture of the membranes —water breaking before labor starts.


RESOURCES:
American Congress of Obstetricians and Gynecologists

American Pregnancy Association

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada

References:
Alanen A. Polymerase chain reaction in the detection of microbes in amniotic fluid. Ann Med . 1998;30:288-295.

Bacterial vaginosis (BV). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 25, 2012. Accessed March 12, 2013.

Bacterial vaginosis—CDC fact sheet. Centers for Disease Control website. Available at: http://www.cdc.gov/std/BV/STDFact-Bacterial-Vaginosis.htm . Updated September 1, 2010. Accessed March 12, 2013.

Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. MMWR . 2002;51:13-15.

Chorioamnionitis. Cleveland Clinic Health Information Center website. Available at: http://www.clevelandclinic.org/health/health-info/docs/3800/3857.asp?index=12309 . Accessed March 12, 2013.

Churgay CA, Smith MA, Blok B. Maternal fever during labor—what does it mean? J Am Board Fam Pract . 1994;7:14-24.

Edwards RK. Chorioamnionitis and labor. Obstet Gynecol Clin North Am . 2005;32:287-296.

Eschenback D, Gravett M, Willoughby R. Infectious diseases, preterm delivery, and infant outcomes. Emerg Infect Dis November 2004.

Gabbe S, Niebyl J, Simpson JL, eds. Normal and Problem Pregnancies . 4th ed. Oxford, UK: Churchill Livingstone, Inc.; 2002.

Greenwald J. Premature rupture of the membranes: diagnostic and management strategies. Am Fam Physician August 1993.

Protect your baby from group B strep. Centers for Disease Control website. Available at: http://www.cdc.gov/groupBstrep/prevention_spot/ . Updated September 18, 2012. Accessed March 12, 2013.

Use of prophylactic antibiotics in labor and delivery. The American Congress of Obstetricians and Gynecologists, Practice Bulletin No. 120 . June 2011.

Wellbery C. Neonate CBC and maternal chorioamnionitis. Am Fam Physician March 2005.

Last Reviewed March 2013