Chorioamnionitis and Uterine Function

Variables Associated with the Early Failure of Nasal CPAP in Very Low Birth Weight Infants

“…8 Infant variables included birth weight, postmenstrual age (PMA), presence of small for gestational age (SGA; weight for PMA below 10 th Lubchenko percentile), 9 Apgar scores, delivery room management (PPV via a bag and mask or via an endotracheal tube), indices of severity of the respiratory distress (severity of RDS on the initial chest x-ray, PaO 2 / FIO 2 ratio, alveolar-arterial oxygen tension gradient [A-a DO 2 ] at the time of the first arterial blood gas [ABG]), the duration of oxygen therapy, and neonatal morbidities: pneumothorax, patent ductus arteriosus (PDA; by echocardiography), germinal matrix-intraventricular hemorrhage (IVH; by cranial ultrasonography typically performed at 24-48 hours, 7 days, 3-4 weeks, and 6-8 weeks of age), severe IVH (grades III-IV), presence of retinopathy of prematurity (ROP; any grade by 32 weeks PMA with weekly or bi-weekly followup), severe ROP (requiring photocoagulation), necrotizing enterocolitis (clinical and surgical diagnoses), CLD, moderate-severe CLD, and mortality. For the purposes of these comparisons, CLD was defined according to the new classification, which differentiated three groups of preterm infants with CLD <32 weeks gestation.…”

Twenty-four percent of patients with clinical chorioamnionitis in preterm gestations have no evidence of either culture-proven intraamniotic infection or intraamniotic inflammation

“…Affected mothers have an increased rate of endometritis [2, 15], post-operative wound infections [2, 16], sepsis [17, 18], disseminated intravascular coagulation [19], septic pelvic thrombophlebitis [20, 21], postpartum hemorrhage [22], pelvic abscess [2], and other complications [2, 4, 23–26]. Neonatal complications include congenital sepsis [11, 25, 27–34] as well as localized infections such as pneumonia [27, 28], dermatitis [35], and otitis media [36]. In addition, clinical chorioamnionitis has been associated with an increased risk of long-term complications such as cerebral palsy [30, 37–44].…”

Septic Shock in Obstetrics and Gynecology

“…The most common organisms isolated in up to 47% and 30% respectively, in cases of culture confirmed chorioamnionitis are Ureaplasma urealyticum and Mycoplasma hominis 40,41 . Chrorioamnionitis leads to a 2 to 3-fold increased risk for caesarean delivery and to 2 to 4-fold increase in endomyometritis, would infection, pelvic abscess, bacteremia, and postpartum hemorrhage [42][43][44] . Women with chorioamnionitis in 10% have positive blood cultures (bacteremia) 36 .…”