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What is Chorioamnionitis? Understanding Risks, Symptoms, and Treatments


 Pregnancy is an incredible journey filled with excitement and anticipation, but like any medical process, it comes with potential risks. One condition that can arise during labor is chorioamnionitis, an infection of the amniotic fluid, membranes, and placenta. Though it sounds serious—and it can be—understanding what chorioamnionitis is, why it happens, and how it’s treated can help you feel more informed and prepared.

In this post, we’ll explore the causes, symptoms, risks, and treatment options for chorioamnionitis. We’ll also discuss how to reduce your risk and how a doula can provide support if this condition occurs during labor.

What is Chorioamnionitis?

Chorioamnionitis, also known as intra-amniotic infection, occurs when bacteria infect the amniotic sac and fluid, which protect the baby during pregnancy. It typically develops when bacteria from the lower genital tract travel upward into the uterus, especially after prolonged rupture of membranes.

According to a review in The Lancet, chorioamnionitis affects approximately 4–10% of all births, making it a relatively common labor complication. Although serious, timely diagnosis and treatment allow most mothers and babies to recover fully.

What Causes Chorioamnionitis?

The primary cause of chorioamnionitis is a bacterial infection. Common bacteria implicated include:

  • Group B Streptococcus (GBS): Naturally found in the vagina and rectum, GBS is a leading cause of infection during labor.
  • Escherichia coli (E. coli): A common bacterium from the gastrointestinal tract that can ascend into the uterus.
  • Anaerobic bacteria: These bacteria thrive in low-oxygen environments, such as the uterus after membrane rupture.

Risk Factors for Chorioamnionitis

  1. Prolonged Rupture of Membranes (PROM):

    • After the water breaks, the protective barrier around the baby is gone, increasing the risk of bacterial infection. Studies show that the risk of chorioamnionitis rises significantly after 18 hours of membrane rupture.

  2. Prolonged Labor:

    • Longer labor increases the likelihood of infection, particularly when combined with frequent vaginal exams.

  3. Frequent Vaginal Exams:

    • Each exam introduces a small risk of bacteria entering the uterus, particularly after membrane rupture.

  4. Preterm Labor:

    • Preterm births carry a higher risk of infection, as the baby’s immune system and skin barrier are less developed.

  5. Internal Monitoring Devices:

    • Tools like intrauterine pressure catheters or fetal scalp electrodes, though helpful for monitoring, can slightly increase the risk of introducing bacteria.

What Are the Symptoms of Chorioamnionitis?

Recognizing the signs of chorioamnionitis is crucial for timely intervention. Common symptoms include:

  • Maternal Fever: A temperature of 100.4°F (38°C) or higher is a hallmark sign.
  • Uterine Tenderness: The uterus may feel sore or painful to the touch.
  • Tachycardia: Elevated heart rates in both mother (>120 bpm) and baby (>160 bpm) can indicate infection.
  • Foul-Smelling Amniotic Fluid: A strong, unpleasant odor can signal bacterial contamination.
  • Flu-Like Symptoms: Sweating, chills, or feeling unwell often accompany a fever.
  • Abnormal Contractions: The infection can affect the strength and frequency of contractions.

How is Chorioamnionitis Diagnosed?

Diagnosis typically involves a combination of clinical observations and laboratory tests:

  1. Physical Exam:

    • Your provider will check for fever, uterine tenderness, and other physical signs of infection.

  2. Fetal Monitoring:

    • Abnormal fetal heart rate patterns, such as persistent tachycardia, may indicate fetal stress due to infection.

  3. Blood Tests:

    • Elevated white blood cell counts or inflammatory markers in maternal blood suggest infection.

  4. Amniotic Fluid Analysis:

    • In some cases, a sample of amniotic fluid is tested to identify the presence of bacteria or inflammation.

What Are the Risks of Chorioamnionitis?

If untreated, chorioamnionitis can pose significant risks for both mother and baby.

Maternal Risks:

  • Postpartum Infections: Conditions like endometritis (uterine lining infection) can develop after delivery.
  • Cesarean Delivery Complications: Infection increases the likelihood of a C-section and associated risks, such as surgical site infections.
  • Sepsis: Though rare, severe systemic infection can occur if the bacteria spread beyond the uterus.

Fetal Risks:

  • Neonatal Infections: Conditions like pneumonia, sepsis, or meningitis are common in newborns exposed to chorioamnionitis.
  • Respiratory Distress Syndrome (RDS): Infection may impair lung function at birth.
  • NICU Admission: Many babies exposed to chorioamnionitis require specialized care after delivery.

How is Chorioamnionitis Treated?

Early and aggressive treatment significantly reduces the risks associated with chorioamnionitis. Treatment typically includes:

  1. IV Antibiotics During Labor:

    • Broad-spectrum antibiotics, such as ampicillin and gentamicin, are commonly used to target the infection and reduce the risk of neonatal transmission.

  2. Prompt Delivery:

    • In most cases, healthcare providers aim to deliver the baby as soon as it is safe to minimize infection-related complications.

  3. Postpartum Antibiotics:

    • If symptoms persist after delivery, additional antibiotics may be needed to treat lingering infection.

With appropriate care, the majority of mothers and babies recover fully.

Can Chorioamnionitis Be Prevented?

While not all cases can be avoided, certain strategies can reduce your risk:

  1. Limit Vaginal Exams:

    • If your water has broken, minimizing the number of vaginal exams can reduce the introduction of bacteria.

  2. Treat Group B Strep (GBS):

    • Routine screening for GBS in late pregnancy (35–37 weeks) allows for prophylactic antibiotic treatment during labor, which reduces infection risks by 80%.

  3. Maintain Hydration and Nutrition:

    • Staying hydrated and nourished supports your immune system and overall health during labor.

  4. Advocate for Safe Monitoring Practices:

    • Discuss alternatives to internal monitoring devices if they are not essential.

How a Doula Can Help

A doula can provide essential support if chorioamnionitis arises during labor:

  1. Emotional Reassurance:

    • A doula offers calm, steady support, helping you manage anxiety about unexpected complications.

  2. Advocacy:

    • Your doula can communicate your preferences to the care team, ensuring decisions align with your birth plan whenever possible.

  3. Comfort Measures:

    • If medical interventions are needed, your doula can suggest techniques like massage, repositioning, and breathing exercises to keep you comfortable.

  4. Postpartum Support:

    • Recovery from chorioamnionitis can take extra time, and a doula can provide guidance as you heal and care for your newborn.

Final Thoughts

Chorioamnionitis is a serious condition, but with proper medical care, it is manageable. Understanding the risks, symptoms, and treatments can help you feel prepared and empowered if it arises during labor.

If you’re planning your labor and want personalized support from someone who understands the complexities of conditions like chorioamnionitis, I’d love to help. As a certified doula, I provide compassionate, evidence-based care tailored to your unique needs.

For more information or to book a consultation, visit www.inducedwithcare.com. Together, we’ll create a plan to help you feel confident and supported on your journey to motherhood.



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