Chorioamnionitis, a condition with a long-winded name, is, to put it simply, an infection in the membranes and fluid around the baby.
It certainly sounds a little scary and, in fact, it could make you and your baby quite unwell.
As with all things in pregnancy and labor, it’s best to do your reading early in the pregnancy. Although it’s unlikely you will experience chorioamnionitis, we recommend you have a quick read to make sure you’re informed.
What is chorioamnionitis?
Chorioamnionitis is a condition that can affect pregnant women and their babies. The most common reason is premature rupture of membranes.
Chorioamnionitis is a bacterial intrauterine infection in the chorion and amnion membranes, including the amniotic fluid around the baby.
Both mother and baby can be affected by chorioamnionitis. As there can be serious complications, treatment is very important.
What causes chorioamnionitis?
A bacterial infection causes chorioamnionitis. The type of bacteria responsible is usually found in the vagina or colon.
Preterm premature rupture of membranes (PPROM) might cause the bacteria in the vagina to move into the uterus. The longer the membranes have been ruptured, the higher the chances of a chorioamnionitis infection.
Chorionic Villus Sampling (CVS) can pose an increased risk of uterine infection (chorioamnionitis) and is one of the possible reasons for miscarriage after either CVS or amniocentesis.
What are the symptoms of chorioamnionitis?
It’s vital to contact your health care provider if you have any of the following symptoms:
- Fever
- Vaginal discharge that has an unpleasant smell due to abnormal vaginal flora
- Increased heart rate for mother (tachycardia) and baby (fetal tachycardia)
- Abdominal and/or uterine tenderness
- Odor in the amniotic fluid
- Vaginal inflammation due to bacterial vaginosis.
Early treatment of chorioamnionitis might reduce the serious adverse neonatal outcomes and adult respiratory distress syndrome that can occur with this intra-amniotic infection.
Why is chorioamnionitis a concern?
Acute chorioamnionitis bacterial infection in the mother could lead to spontaneous preterm labor and birth or a likely c section; there could be other complications for baby, such as meningitis or pneumonia.
Early onset neonatal sepsis (baby infection) can cause fetal inflammatory response syndrome (whole-body type of inflammation in the newborn). If this occurs in a baby, it’s considered a life-threatening situation.
What are the risks with chorioamnionitis?
Common risk factors with the development of chorioamnionitis can include preterm premature rupture of membranes (PPROM) if you have a long labor, high blood pressure, and you’re having your first baby.
You might be interested in reading Premature Rupture Of Membranes – When Your Water Breaks Prematurely.
A further risk, due to chorioamnionitis, is that Preterm Labor might occur for the mother and there could be early onset neonatal sepsis for baby.
If you are concerned, make sure you contact your health care professional for more information.
How is chorioamnionitis diagnosed?
Speak with your midwife or other health care professional for an accurate diagnosis of clinical chorioamnionitis, as this can have serious complications for you and your baby.
The doctors will complete an assessment, with your informed consent, to check your observations, order an ultrasound, take some vaginal swabs and, in some cases, take a sample of the amniotic fluid.
Treatment for chorioamnionitis
You will be admitted to the Maternity Unit for a full assessment and treatment. The obstetric team will probably put an IV line into your vein for the medications to be administered and, if you require a C Section, for spinal or epidural anesthesia.
The standard treatment for chorioamnionitis is broad-spectrum antibiotics for you and your baby. The doctor might recommend baby be birthed early, due to the risk factor of chorioamnionitis; preterm infants might also require some assistance at the time of birth. A paediatrician should have a chat with you about this, as will your primary carer.
For more information, you might be interested in Antibiotics During Labour – Risks and Benefits.
All decisions are yours to make and your informed consent is required at all times. Having the right information, and weighing up the risks against the benefits will help you make choices that you feel are right for you and your baby.
Can chorioamnionitis be asymptomatic?
Usually, you will have some symptoms; you might not know, however, that you have chorioamnionitis in the fetal membranes and fluid.
The subclinical infection causes an inflammatory response in the two layers of the membranes – called the amnion and the chorion – and causes placental inflammation. This can occur without maternal fever or any other risk factors.
Most common organisms in chorioamnionitis
The most common organisms in chorioamnionitis are anaerobic bacteria group B streptococci. Group B lives in the colon or vagina and travels to the womb, causing chorioamnionitis.
Other bacteria, such as mycoplasma hominis and ureaplasma, are also commonly found in the lower genital tract of most pregnant women.
