Chorioamnionitis

 

What is chorioamnionitis?

 Chorioamnionitis is an infection of the two layers of the placenta tissue (the chorion and the amnion) and the amniotic fluid (fluid that surrounds your baby). It occurs in about 1- 2% of all pregnancies and is commonly caused by bacteria that is usually found in the vagina such as E.Coli and Group B streptoccocus which could track upwards after your waterbag has been broken for an extended period of time.
What are the symptoms of chorioamnionitis?
  • Fever
  • Abdominal pain
  • Increased heart rate of the mother and baby
  • Foul smelling discharge of the vagina which could be greenish in colour
How is the diagnosis made?
Your doctor may make the diagnosis based on your symptoms and / or the results of your blood investigation i.e full blood count and CRP (C-Reactive protein) which shows evidence of infection. Rarely, testing of the amniotic fluid (amniocentesis) will be done to confirm the diagnosis.
Who are at risk of developing chorioamnionitis?

 

What are the complications of chorioamnionitis?

 It could effect both you and your baby with potentially serious consequences:
  • Infection in the womb (endometritis) and pus collection in the pelvis
  • Invasion of bacteria in the mother’s blood leading to overwhelming infection (sepsis)
  • Could affect labour by causing prolonged labour and Bleeding during delivery. There is increased risk of Caesarean section.
  • Infection in the baby that could also caused sepsis, meningitis (infection of the lining of the brain and spinal cord) and respiratory problems.
What is the treatment for chorioamnionitis?
Every patient’s treatment needs to be individualised. You need to speak to your doctor about your management if you have chorioamnionitis which will depend on several factors such as your overall health and medical history, how far along are you and the condition of your baby. Antibiotics will be prescribed to cover for the infection before and after delivery. In most cases, your baby will need to be delivered to reduce the risk to both you and your baby. The long term outcome for majority of mothers and their babies are good. In general, future fertility is rarely compromised.
How could I prevent chorioamnionitis?
  • See your doctor if you have abnormal vaginal discharge during pregnancy. You could be infected with bacterial vaginosis or Group B streptoccus which increases your risk of having preterm premature rupture of membranes
  • If you have no symptoms, you may want to ask you doctor regarding screening for Group B streptococcus at 35 – 37 weeks of pregnancy.
  • During labour, by reducing the number of vaginal examination and rupturing the membranes only when is necessary to do so may help reduce risk of chorioamnionitis.

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