Chorioamnionitis Classification and external resources
Micrograph showing chorioamnionitis. The clusters of blue dots are inflammatory cells (neutrophils, eosinophils and lymphocytes). H&E stain.
ICD-10 O41.1, P02.7 ICD-9 658.4, 762.7 eMedicine ped/89 MeSH D002821
Chorioamnionitis is an inflammation of the fetal membranes (amnion and chorion) due to a bacterial infection. It typically results from bacteria ascending into the uterus from the vagina and is most often associated with prolonged labour. Risk of developing chorioamnionitis increases with each vaginal exam during final month of pregnancy and during labor.
The fetal membranes consist of two parts:
- The outer membrane is the chorion. It is closest to the mother and physically supports the much thinner amnion.
- The inner membrane is the amnion. It is in direct contact with the amniotic fluid, which surrounds the fetus.
Chorioamnionitis is diagnosed clinically in the setting of:
- maternal fever.
- uterine tenderness in the presence of confirmed premature rupture of membranes (PROM).
- maternal upper respiratory infection.
- maternal urinary tract infection.
Chorioamnionitis can be diagnosed from a histologic examination of the fetal membranes.
Infiltration of the chorionic plate by neutrophils is diagnostic of (mild) chorioamnionitis. More severe chorioamnionitis involves subamniotic tissue and may have fetal membrane necrosis and/or abscess formation.
Severe chorioamnionitis may be accompanied by vasculitis of the umbilical vessels (due to the fetus' inflammatory cells) and, if very severe, funisitis (inflammation of the umbilical cord's connective tissue).
Treatment consists of:
- antibiotics (amoxicillin + gentamicin + metronidazole) for the mother, and
- quickly delivering the baby.
- ^ Elmar Peter Sakala, MD, MA, MPH, FACOG. Professor of GYNOB, Loma Linda University of medicine, California. Codirector of Student Clerkship. Dept of GYNOB
- ^ Wu YW, Colford JM (2000). "Chorioamnionitis as a risk factor for cerebral palsy: A meta-analysis". JAMA 284 (11): 1417–24. doi:10.1001/jama.284.11.1417. PMID 10989405.
3. Excess Digital Exams Raise Risk of Chorioamnionitis, Ob.Gyn. News, August 15, 1997
Pathology of pregnancy, childbirth and the puerperium (O, 630–679) PregnancyPregnancy with
abortive outcomeOedema, proteinuria and
hypertensive disordersOther, predominantly
related to pregnancyGestational thrombocytopenia · Pregnancy-induced hypercoagulabilityamniotic fluid (Polyhydramnios, Oligohydramnios) · chorion/amnion (Chorioamnionitis, Chorionic hematoma, Premature rupture of membranes, Amniotic band syndrome, Monoamniotic twins) · placenta (Placenta praevia, Placental abruption, Monochorionic twins, Twin-to-twin transfusion syndrome, Circumvallate placenta) · Braxton Hicks contractions · Hemorrhage (Antepartum)
Labor Puerperal Other Certain conditions originating in the perinatal period / fetal disease (P, 760–779) Maternal factors and
complications of pregnancy,
labour and delivery
Length of gestation
and fetal growth
Birth trauma By systemIntegument and
temperature regulationErythema toxicum · Sclerema neonatorum
Infectious Other Inflammation Acute Chronic Processes Specific locationsCardiovascularDigestivemouth (Stomatitis, Gingivitis, Gingivostomatitis, Glossitis, Tonsillitis, Sialadenitis/Parotitis, Cheilitis, Pulpitis, Gnathitis) · tract (Esophagitis, Gastritis, Gastroenteritis, Enteritis, Colitis, Enterocolitis, Duodenitis, Ileitis, Caecitis, Appendicitis, Proctitis) · accessory (Hepatitis, Cholangitis, Cholecystitis, Pancreatitis) · Peritonitis
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