Chorioamnionitis

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chorioamnionitis - intermed mag

Histopathology of acute choriodeciduitis

Chorioamnionitis, also known as intra-amniotic infection (IAI), is a bacterial infection that affects the chorion, amnion, and amniotic fluid around the fetus during pregnancy. This condition is a significant cause of preterm birth and can have serious consequences for both the mother and the fetus. It typically arises from a bacterial infection that ascends from the lower genital tract into the uterine cavity. The diagnosis is often based on clinical findings, including maternal fever, uterine tenderness, and foul-smelling amniotic fluid, although laboratory tests can provide further confirmation.

Causes and Risk Factors

The primary cause of chorioamnionitis is infection by bacteria, most commonly involving species such as Escherichia coli, group B Streptococcus, and anaerobic bacteria. Risk factors for developing chorioamnionitis include prolonged labor, premature rupture of membranes (PROM), multiple vaginal examinations during labor, and the use of internal monitoring devices. Women with a history of preterm delivery or those who have had invasive procedures during pregnancy, such as amniocentesis, are also at increased risk.

Symptoms and Diagnosis

Symptoms of chorioamnionitis can vary but often include maternal fever, increased heart rate in the mother or fetus, uterine tenderness, and foul-smelling amniotic fluid. Diagnosis is primarily clinical but can be supported by laboratory tests such as elevated maternal white blood cell count, elevated C-reactive protein, and amniotic fluid analysis showing signs of infection.

Treatment

Treatment for chorioamnionitis typically involves the administration of broad-spectrum antibiotics to the mother. In cases where the pregnancy is at a viable gestational age, delivery is often the recommended course of action to prevent further infection and potential harm to the fetus. Management strategies may also include supportive care for the mother and monitoring for signs of fetal distress.

Complications

Chorioamnionitis can lead to several serious complications, including preterm birth, neonatal sepsis, pulmonary hypoplasia in the fetus, and increased risk of cesarean section for the mother. Long-term, children born from pregnancies complicated by chorioamnionitis may face increased risks of cerebral palsy and other developmental issues.

Prevention

Preventive measures for chorioamnionitis focus on minimizing risk factors, such as reducing the number of vaginal examinations during labor and avoiding unnecessary invasive procedures during pregnancy. Early and effective treatment of vaginal infections during pregnancy can also reduce the risk of ascending infections leading to chorioamnionitis.