What is Chorioamnionitis?
Chorioamnionitis is a condition that develops often during the intra part of or labor period for the mother. It is an infection of the lining of the uterus and can result in harm to both the mother and the fetus.
How is Chorioamnionitis diagnosed?
It is most often diagnosed from a clinical presentation that includes an elevated maternal heart rate, an elevated fetal heart rate, malodorous smell from the mother, in addition to maternal tachypnea.
Why does Chorioamnionitis happen?
Chorioamnionitis often results from rupture of membranes. That is when the water breaks. When the water breaks, that presents a pathway for offending organisms to go up into the cervix and into the uterus.
How is Chorioamnionitis treated?
The treatment for a patient in labor is prompt administration of antibiotics such as ampicillin and gentamicin in addition to delivery. The treatment does not indicate an emergent delivery, just that delivery needs to take place in a period of time such that the infection does not spread to the baby which would then cause injury.
For example, if a mother comes in and has all of the clinical signs and symptoms of chorioamnionitis but is in the early stages of labor and is looking at a 20‑hour period before her baby is born, if all of the clinical signs are present and then the baby starts showing signs of deterioration on the electronic fetal heart rate monitor, the standard of care would be to deliver the baby as soon as possible and not to let the mother undergo a course of labor when it is predictable that the labor could take 20 hours.
Leaving a baby in such an environment for an extended period of time is going to increase the likelihood that the infection is going to spread. Although the diagnosis is one that is made clinically, it can also be made pathologically once the baby is born. Once the baby is born, the placenta is removed from the uterus and expelled from the uterus and is sent for examination. Certain findings on pathology can be consistent with chorioamnionitis in a condition called funisitis which is an associated infection of the umbilical cord. If pathology shows that chorioamnionitis is present, there is a likelihood that the infection has been longstanding.
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