What Is Chorioamnionitis and Why Is It Important?
What is Chorioamnionitis?
Chorioamnionitis is a condition that affects the membrane and amniotic fluid by bacterial infection. It is also known as intra-amniotic infection. Do you know that chorioamnionitis incidents are 5% in term infants and anywhere between 30 - 70% in pre-term infants? (1). The name chorioamnionitis is arrived by referring to the 2 membranes surrounding the fetus in the uterus known as chorion and amnion. Chronic chorioamnionitis is associated with low birth weight, premature labor, and impaired brain development of the fetus. This chorioamnionitis leads to morbidity and mortality for both the fetus and the mother if left untreated. This bacterial infection can enter the tissues or membrane around the uterus. The membrane includes,
- Chorion
- Amnion
- Placenta
- Amniotic fluid
What are the Causes of Chorioamnionitis?
- The Chorioamnionitis has the clinical symptoms such as,
- Fever greater than 100.4,
- Uterine tenderness or pain,
- Rapid heart rate of fetus greater than 160 per minute,
- The rapid heart rate of the mother greater than 100 per minute,
- Foul-smelling vaginal Discharge,
- Unusual color of the vaginal,
- Sweating.
What are the causes of Chorioamnionitis?
- E.coli is a group of bacteria that can cause infections in the Gut, Urinary tract, and other body parts. This bacterial infection can cause watery diarrhea, vomiting, and fever.
- Group B Strep is an infection caused at the time of delivery or the first week of the infant’s life. This infection will be screened in pregnant women, and if the test result is positive, then antibiotics will be suggested.
The Diagnosis Procedure of Chorioamnionitis:
- Blood tests such as CBC, CRP, and LBP to know the status of the White Blood Cell count and other abnormalities in the blood (2).
- Urine test to check whether infection is there.
- Taking a tiny sample of the amniotic fluid to check the presence of bacteria.
- Vaginal culture test to check for bacteria.
- Doing an ultrasound to check the health of the fetus.
What are the available treatment methods for Chorioamnionitis?
- The treatment for chorioamnionitis is antibiotic Therapy.
- The most common antibiotics prescribed for chorioamnionitis are ampicillin and gentamicin (3).
- In some cases, the healthcare providers advise delivering the baby earlier by considering the infection should not spread to the infant.
- If the delivery is a c-section, the current advice is to administer one additional dose, whereas, no additional dose is recommended for vaginal delivery.
- If the neonatal has been infected, then antibiotics will be provided to the infant.
- Depending on the clinical status, additional broad-spectrum antibiotics will be required.
Complications associated with the Chorioamnionitis:
- The complications associated with Chorioamnionitis, after it has been diagnosed and left untreated, are (4),
- Severe infection in the pelvic region of the delivered mother.
- Endometritis or inflammatory uterus walls.
- Sepsis which is the infection gets spread over the body.
- Blood Clots in the pelvic region.
- Brain and Spinal cord inflammation in the infant.
- Pneumonia in the infant.
Are there any preventive measures available for Chorioamnionitis?
- Yes, it is possible to reduce the risk of chorioamnionitis. Those factors are,
- Getting antibiotics in the situation of early water break.
- Limiting the vaginal examination often after the water break as it increases the risk of getting infected.
- Test in the third trimester if the woman has Group B steps infection.
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