Chorioamnionitis
Suspected intra-amniotic infection is usually an ascending infection associated with ruptured membranes; it can cause maternal sepsis, fetal compromise and early-onset neonatal infection, so prompt senior assessment, antibiotics and a birth plan are required.
Definition
Chorioamnionitis, also called intra-amniotic infection, is infection and inflammation involving the fetal membranes, amniotic fluid and sometimes the placenta and decidua. It is usually caused by organisms ascending from the lower genital tract, particularly after rupture of membranes, and is diagnosed from the whole clinical picture rather than a single test.
First principles
Treat the clinical syndrome, not one laboratory result
Intra-amniotic infection is often diagnosed clinically from maternal fever or systemic illness with supporting features such as uterine tenderness, maternal or fetal tachycardia, purulent or offensive liquor, or an inflammatory response. In PPROM, combine clinical assessment, maternal blood tests and fetal heart-rate assessment; do not use CRP, white cell count or CTG in isolation.
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