Chorioamnionitis

Abstract

Chorioamnionitis most often occurs during labor, affecting as many as 10% of laboring women. When intrapartum chorioamnionitis occurs, women are at peripartal risk for endometritis, cesarean birth, and postpartum hemorrhage; and the neonate is at significant risk for sepsis, pneumonia, respiratory distress, and death. The impact is greater for preterm infants where the incidence of chorioamnionitis is nearly 30%. When chorioamnionitis is believed to be present, antibiotics are administered, but not without potential adverse consequence to the mother/fetus, as well as significantly increased healthcare cost. A number of factors increase the risk of chorioamnionitis, including use of intrauterine pressure catheters and fetal scalp electrodes, urogenital tract infections, prolonged rupture of membranes, digital vaginal examinations, and the nature of perineal hygiene. This article presents key intrapartum factors and those nursing actions that can help to reduce rates of chorioamnionitis and improve perinatal outcomes.

Associations of treated and untreated human papillomavirus infection with preterm delivery and neonatal mortality: A Swedish population-based study

“…To the best of our knowledge, this is the first study to demonstrate that it is not only the risk of pPROM but also the risk of PROM at term that is increased after treatment for CIN. Infection is considered to be an important cause of PTD and pPROM [ 9 ], while deliveries after pPROM and PROM also entail increased risk of infectious complications [ 33 ]. Our results could be explained by an increased risk of ascending bacterial infection in women previously treated for CIN, causing PTD, pPROM, chorioamnionitis, and neonatal sepsis.…”

Maternal human papillomavirus infection during pregnancy and preterm delivery: A mother–child cohort study in Norway and Sweden

“…This risk is also increased in deliveries starting with prelabor rupture of membranes (PROM) at term. 5 Cervicovaginal dysbiosis confers increased risk for PTD. 4 Why bacteria ascend from the lower genital tract to the uterus and cause PTD and chorioamnionitis in some women remains unexplained, but the mucosal immunity and the microbial ecosystem in the lower genital tract are key factors.…”

“…An intrauterine bacterial infection causing spontaneous PTD is often subclinical; however, PTDs, especially if starting with preterm prelabor rupture of the membranes (PPROM), are at increased risk of infectious complications of the mother and the newborn. This risk is also increased in deliveries starting with prelabor rupture of membranes (PROM) at term 5 . Cervicovaginal dysbiosis confers increased risk for PTD 4 .…”

Aerococcus christensenii as Part of Severe Polymicrobial Chorioamnionitis in a Pregnant Woman

“…Chorioamnionitis is an infection of the fetal membranes, thought to affect as many as 10 % of all labouring women [ 1 ] and it is a major challenge with regard to secure the mother as well as the foetus from life threatening complications. In term pregnancies it is thought to be caused primarily by ascending infections from the vagina and cervix, causing an inflammatory response in the decidua followed by a chorionitis [ 2 ].…”

“…A. christensenii, Gemella asaccharolytica and Snethia (Leptotrichia) sanguinegens [ 5 , 6 ] are relatively newly established taxons and have only rarely to very rarely been alleged to cause invasive infections. During labour, increased vaginal secretions are common, creating a favourable medium for growth of bacteria, which can ascend and stimulate maternal and foetal inflammatory responses with the release of cytokines, prostaglandins and endotoxins [ 1 ]. Applicating molecular laboratory methods may contribute considerably in diagnostic outlining of these organisms [ 7 ].…”