Chorioamnionitis : Causes, Symptoms, Diagnosis, Treatment, Risk Factors

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Chorioamnionitis
Chorioamnionitis : Causes, Symptoms, Treatment, Risk Factors &and Complications

Overview

Chorioamnionitis is a severe health condition in pregnant women. This condition occurs when bacteria infect the membranes that surround the fetus and also affect the amniotic fluid. If left untreated, chorioamnionitis can cause severe complications in the mother and baby.

This blog is a comprehensive understanding of chorioamnionitis, its causes, symptoms, risk factors, complications, and treatment.

What is chorioamnionitis?

Chorioamnionitis is a severe bacterial infection that affects the chorion, amnion, and amniotic fluid around the fetus. The condition can develop before or during labour. The condition may cause preterm birth or cause severe infections in women and children. It is important to note that it is most commonly seen in preterm births and 2 to 4 per cent of full-term deliveries.

What are the symptoms of chorioamnionitis?

Though chorioamnionitis does not always cause symptoms, some women with this condition may experience:

  • Sweating
  • High temperature and fever
  • Rapid heartbeat (the fetus can also have a fast heartbeat)
  • Uterine tenderness
  • Discolored, foul-smelling amniotic fluid

When should women call the doctor?

If the membranes rupture, women must seek medical help immediately. The other symptoms that require urgent medical care include:

  • Fever
  • Sore or painful uterus
  • Rapid heart rate
  • Foul-smelling amniotic fluid

What are the causes of chorioamnionitis?

Chorioamnionitis is caused due to an infection that can occur when the bacteria usually present in the vagina move up into the uterus, where the fetus is situated. The most common causes of chorioamnionitis are E. coli, group B streptococci, and anaerobic bacteria. 

What are the risk factors for chorioamnionitis?

The risk factors for developing chorioamnionitis increase if women: 

  1. Have very long labour before delivery
  2. Undergo a lot of vaginal exams during labour
  3. Have a sexually transmitted infection
  4. Get epidural anaesthesia during labour
  5. Have membranes that are ruptured (water has broken) for a very long time
  6. Expecting another child and experienced chorioamnionitis during the first pregnancy
  7. Have pre-existing infections of the lower genital tract
  8. Have a short cervix
  9. Use drugs, tobacco, or consume alcohol.
  10. Get internal fetal monitoring during labour
  11. Are immune-compromised
  12. Preterm labour
  13. First pregnancy 

When women have one or more of these risk factors, they are likely to develop chorioamnionitis.

What are the complications of chorioamnionitis?

This is a medical emergency.

When women are suffering from a severe case of chorioamnionitis, or if it is left untreated, they can develop complications, including: 

  • Bacteremia (infection in the bloodstream)
  • Need for cesarean delivery
  • heavy blood loss with delivery
  • Blood clots in the lungs and pelvis
  • Blood clots in the pelvis and lungs
  • Endometritis (inflammation of the inner uterus lining)
  • Sepsis (a life-threatening infection of the blood) 

Babies born with chorioamnionitis are also in danger of severe complications:

  • The condition can cause meningitis, an infection of the lining of brain and spinal cord. But, this happens in less than 1 percent infants who are delivered to term.
  • Pneumonia or bacteremia may also develop in about 5 – 10 percent  babies born to women with chorioamnionitis. Bacteremia is more common in preterm infants.
  • In some rare cases, the complications linked to chorioamnionitis can be life-threatening to preterm infants.

When to seek medical help?

If a pregnant woman experiences any of the above complications, immediately seeking medical assistance helps in the overall health of the mother and child.

How is chorioamnionitis treated?

The doctors immediately treat patients with chorioamnionitis to prevent fever, reduce recovery time, and decrease the risk of infection to the baby. Antibiotics are the most commonly used medications to treat this condition, usually administered through an IV and continued until the delivery or the infection is cleared. Doctors can prescribe some of the following antibiotics:

  1. Ampicillin
  2. Penicillin
  3. Gentamicin
  4. Clindamycin
  5. Metronidazole  

If a woman develops an infection during labour, the doctors administer antibiotics until delivery. The doctor may deliver the baby by caesarean section . The treatment for the baby begins as soon as the baby is born.

Can chorioamnionitis be prevented?

‌‌Chorioamnionitis is preventable. However, there are chances to develop it even after taking preventive measures. The following are some of the preventive measures:

  1. Screening for bacterial vaginosis (vaginal inflammation) during their second trimester
  2. Reducing the number of vaginal exams done during labour
  3. Testing them for group B streptococcal infection once the pregnancy  reaches 35 to 37 weeks of pregnancy
  4. Reducing the frequency of internal monitoring

It is crucial for women to have theor antenatal checks with their doctor and have their questions and concerns addressed so that they can enjoy a healthy, complication-free pregnancy, and delivery.

Conclusion

The prognosis for women suffering from chorioamnionitis is excellent in the long run if detected and treated early . In rare cases, future fertility may be compromised.

The prognosis for babies born to infected women is also generally good .However, some newborns, especially preterm babies, may have long-term complications such as lung disease or impaired brain function. 

Frequently Asked Questions 

1. How is chorioamnionitis diagnosed?

The doctor can  diagnose chorioamnionitis by performing a physical examination. They can also ask for blood culture and urine tests to check for bacteria in the body. A complete blood count (CBC) test examines the white blood cell count and looks for other markers.‌‌ Amniocentesis can be required . Doctors remove a tiny amount of amniotic fluid for testing to perform this prenatal test.

2. What are the other names for chorioamnionitis?

Chorioamnionitis is also called ‘amnionitis’ and ‘intra-amniotic infection.