Chorioamnionitis

Chorioamnionitis is an infection that can occur before labor, during labor, or after delivery. It can be acute, subacute, or chronic. Subacute chorioamnionitis is associated with chronic lung disease in the infant. Chronic chorioamnionitis is associated with retinopathy of prematurity, very low birth weight, and impaired brain development in the premature infant. Chronic chorioamnionitis is common. This terminology refers to histologic chorioamnionitis. Histologic chorioamnionitis at term is rarely infectious. In general, the clinical presentation of chorioamnionitis is defined as acute chorioamnionitis. The Greek etymology of the words chorion and amnion mean fetal membrane, and itis means inflammation. Further description denotes chorioamnionitis includes the amniotic fluid. Chorioamnionitis may be identified postdelivery or postmortem on a pathologic review of the placenta and cord. In histologic chorioamnionitis, symptoms may be absent, and the placenta or cultures may not show evidence of chorioamnionitis. Most commonly, chorioamnionitis is associated with preterm labor, prolonged rupture of membranes, prolonged labor, tobacco use, nulliparous pregnancy, meconium-stained fluid, multiple vaginal exams post rupture of membranes, and in women with known bacterial or viral infections. However, it can occur at term and in women without prior infections. Left untreated, chorioamnionitis can lead to morbidity and mortality for the mother and neonate. Neonatal morbidity and mortality increase in severity and occurrence with earlier gestations. Antibiotic therapy has been shown to reduce the incidence and severity of the infection in both the mother and neonate. However, antibiotics do not eradicate the infection in all cases.