Chorioamnionitis: Difference between revisions
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* 1 to 4% of all birth |
* 1 to 4% of all birth |
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* More common with preterm delivery, PROM, prolonged labour, smoking/alcohol/drug use, multiple vaginal examination, internal monitoring of labour, bacterial vaginosis, colonization by group B streptococcus, and nulliparity |
* More common with preterm delivery, PROM, prolonged labour, smoking/alcohol/drug use, multiple vaginal examination, internal monitoring of labour, bacterial vaginosis, colonization by group B streptococcus, and nulliparity |
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=== Risk Factors === |
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* Prolonged rupture of membranes (including [[PPROM]]) ≥12 hours or ≥18 hours |
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* Prolonged labour, with second stage >2 hours or active labour >12 hours |
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* Multiple digital exams with membrane rupture ≥3 exams |
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* Nulliparity |
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* Colonization with [[group B Streptococcus]] |
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* [[Bacterial vaginosis]] |
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* Alcohol and tobacco use |
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* Meconium-stained amniotic fluid |
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* Internal monitoring of the fetus |
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* Epidural anaesthesia |
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== Clinical Manifestations == |
== Clinical Manifestations == |
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Revision as of 13:38, 10 December 2021
Background
- Ascending bacterial infection leading to inflammation of the membranes and placenta
- Also called intraamniotic infection
Microbiology
- Usually polymicrobial
- Ureaplasma urealyticum (47%)
- Mycoplasma hominis (30%)
- Gardnerella vaginalis (25%)
- Bacteroides species (30%)
- Group B streptococcus (15%)
- Escherichia coli (8%)
Epidemiology
- 1 to 4% of all birth
- More common with preterm delivery, PROM, prolonged labour, smoking/alcohol/drug use, multiple vaginal examination, internal monitoring of labour, bacterial vaginosis, colonization by group B streptococcus, and nulliparity
Risk Factors
- Prolonged rupture of membranes (including PPROM) ≥12 hours or ≥18 hours
- Prolonged labour, with second stage >2 hours or active labour >12 hours
- Multiple digital exams with membrane rupture ≥3 exams
- Nulliparity
- Colonization with group B Streptococcus
- Bacterial vaginosis
- Alcohol and tobacco use
- Meconium-stained amniotic fluid
- Internal monitoring of the fetus
- Epidural anaesthesia
Clinical Manifestations
- Fever, tenderness over the uterine fundus, maternal tachycardia, fetal tachycardia
- May have purulent or malodorous amniotic fluid
- Can be complicated by endometritis, pelvic abscess, surgical site infection, bacteremia, postpartum hemorrhage, and poor neonatal outcomes
References
- a b Alan T.N. Tita, William W. Andrews. Diagnosis and Management of Clinical Chorioamnionitis. Clinics in Perinatology. 2010;37(2):339-354. doi:10.1016/j.clp.2010.02.003.
