Risk factors for intraamniotic infection: A prospective epidemiologic study

Soper, David E.; Mayhall, C. Glen; Dalton, Harry P.

doi:10.1016/0002-9378(89)90356-6

Cited by 234 publications

(47 citation statements)

References 10 publications

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“…Overall, 1–4% of all births in the US are complicated by chorioamnionitis [2]; however, the frequency of chorioamnionitis varies markedly by diagnostic criteria, specific risk factors and gestational age [3–7]. Chorioamnionitis (clinical and histologic combined), complicates as many as 40–70% of preterm births with premature membrane rupture or spontaneous labor [8] and 1–13% of term births [9–11].…”

Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

“…Multiple studies have reported risk factors for chorioamnionitis, including longer duration of membrane rupture, prolonged labor, nulliparity, African American ethnicity, internal monitoring of labor, multiple vaginal exams, meconium-stained amniotic fluid, smoking, alcohol or drug abuse, immune-compromised states, epidural anesthesia, colonization with group B streptococcus, bacterial vaginosis, sexually transmissible genital infections and vaginal colonization with ureaplasma [3–7,13–18]. A strong association between untreated GBS bacteriuria and chorioamnionitis may reflect the high concentration of GBS in the genital tract [19].…”

Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

“…After adjusting for potential confounding variables and depending on the specific confounders considered, some of the risk factors for chorioamnionitis identified in older studies no longer demonstrate an association in recent studies. Select factors independently associated with chorioamnionitis and their strength of association are summarized in Table 1 [3–7,13–17]. Contrary to most obstetric conditions, chorioamnionitis in a previous pregnancy may not be associated with an increased risk of chorioamnionitis in a subsequent pregnancy [20].…”

Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

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Diagnosis and Management of Clinical Chorioamnionitis

Tita

Andrews

2010

Clinics in Perinatology

758

548

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Chorioamnionitis is a common complication of pregnancy associated with significant maternal, perinatal, and long-term adverse outcomes. Adverse maternal outcomes include postpartum infections and sepsis while adverse infant outcomes include stillbirth, premature birth, neonatal sepsis, chronic lung disease and brain injury leading to cerebral palsy and other neurodevelopmental disabilities. Research in the last two decades has expanded our understanding of the mechanistic links between intraamniotic infection and preterm delivery as well as morbidities of preterm and term infants. Recent and ongoing clinical research into better methods for diagnosing, treating and preventing chorioamnionitis is likely to have a substantial impact on short and long-term outcomes in the neonate. KeywordsChorioamnionitis; infection; pregnancy; management DefinitionChorioamnionitis or intraamniotic infection is an acute inflammation of the membranes and chorion of the placenta, typically due to ascending polymicrobial bacterial infection in the setting of membrane rupture. Chorioamnionitis can occur with intact membranes, and this appears to be especially common for the very small fastidious genital mycoplasmas such as Ureaplasma species and Mycoplasma hominis, found in the lower genital tract of over 70% of women [1]. Only rarely is hematogeneous spread implicated in chorioamnionitis, as occurs with Listeria monocytogenes [2]. When characteristic clinical signs are present, the condition is referred to as clinical chorioamnionitis or clinical intraamniotic infection. Although there is significant overlap between clinical and histologic chorioamnionitis, the latter is a more common diagnosis based on pathologic findings on microscopic examination of the placenta that encompasses clinically unapparent (sub-clinical) chorioamnionitis as well as clinical chorioamnionitis. Funisitis, also a histopathologic diagnosis, is the extension of infection or inflammation to the umbilical cord. Overall the definition of chorioamnionitis a Corresponding author for proof and reprints: Dr. Alan T. N. Tita (alan.tita@obgyn.uab.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Epidemiology (incidence and risk factors)Overall, 1-4% of all births in the US are complicated by chorioamnionitis [2]; however, the frequency of chorioamnionitis varies markedly by diagnostic criteria, specific risk factors and gestational age [3][4][5][6][7]. Chorioamnionitis (clinical and histologic combined), complicates as many as 40-70% of preterm births with premature membrane rupture or spontaneous la...

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Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

Section: Epidemiology (Incidence and Risk Factors)mentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and Management of Clinical Chorioamnionitis

Tita

Andrews

2010

Clinics in Perinatology

758

548

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“…Most studies, including those with active management, perform cervical exams every 2 hours in labor. The risk of chorioamnionitis though increases with increasing number of exams (49).…”

Section: Frequency Of Cervical Examsmentioning

confidence: 99%

Before labor and first stage of labor

Berghella¹

2012

Obstetric Evidence Based Guidelines

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“…3 Among various pathogens resulting in chorioamnionitis, the most prevalent are Ureaplasma urealyticum, Myeloplasma hominis, and Prevotella bivius. 4 5 However, there have been no reports describing chorioamnionitis caused by S marcescens.…”

mentioning

confidence: 99%

Chorioamnionitis caused by Serratia marcescens in a non-immunocompromised host

Shimizu

Kojima²,

Yoshida³

et al. 2003

Journal of Clinical Pathology

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A 26 year old pregnant woman with antithrombin III deficiency developed recurrent septicaemia with Serratia marcescens. In spite of the administration of antibiotics, high grade fever persisted. She subsequently manifested lower abdominal pain, and spontaneous abortion occurred. After the abortion, she became completely afebrile. The amnion was turbid, and microscopic examination of the placenta showed haemorrhage and massive infiltration of neutrophils, suggestive of infectious chorioamnionitis. Pulsed field gel electrophoresis showed that isolates from the blood, urine, and vaginal discharge were genetically identical. Intravenous pyelography revealed that she had a bilateral completed double ureter. It was thought that a urinary tract anomaly caused infection with S marcescens, and the pathogen spread to the chorioamnion via the bloodstream. This is the first report of chorioamnionitis caused by S marcescens in a non-immunocompromised host. In addition, these findings indicate that the chorioamnion can serve as a site for persistent infection in normal pregnancies.

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Risk factors for intraamniotic infection: A prospective epidemiologic study

Cited by 234 publications

References 10 publications

Diagnosis and Management of Clinical Chorioamnionitis

Diagnosis and Management of Clinical Chorioamnionitis

Before labor and first stage of labor

Chorioamnionitis caused by Serratia marcescens in a non-immunocompromised host

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