Chorioamnionitis

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

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