Chorioamnionitis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Clinical findings associated with chorioamnionitis include maternal [[fever]], [[uterine]] tenderness, purulent/foul-smelling [[amniotic fluid]], maternal/fetal [[tachycardia]]. Common fetal complications of chorioamnionitis include [[preterm birth]], [[neonatal sepsis]], [[neurologic]] complications, [[respiratory]] complications. Common maternal complications of chorioamnionitis include maternal [[sepsis]], [[infections]], and [[childbirth|Labor]]-related complications (e.g., [[cesarean section]], [[postpartum hemorrhage]], etc.) | |||
==Natural History== | ==Natural History== | ||
The symptoms of chorioamnionitis usually develop during the pregnancy, and start with symptoms such as maternal [[fever]], [[uterine]] tenderness, purulent/foul-smelling [[amniotic fluid]], maternal/fetal [[tachycardia]].<ref name="pmid20569811">{{cite journal |vauthors=Tita AT, Andrews WW |title=Diagnosis and management of clinical chorioamnionitis |journal=Clin Perinatol |volume=37 |issue=2 |pages=339–54 |date=June 2010 |pmid=20569811 |pmc=3008318 |doi=10.1016/j.clp.2010.02.003 |url=}}</ref> | The symptoms of chorioamnionitis usually develop during the pregnancy, and start with symptoms such as maternal [[fever]], [[uterine]] tenderness, purulent/foul-smelling [[amniotic fluid]], maternal/fetal [[tachycardia]].<ref name="pmid20569811">{{cite journal |vauthors=Tita AT, Andrews WW |title=Diagnosis and management of clinical chorioamnionitis |journal=Clin Perinatol |volume=37 |issue=2 |pages=339–54 |date=June 2010 |pmid=20569811 |pmc=3008318 |doi=10.1016/j.clp.2010.02.003 |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2]
Overview
Clinical findings associated with chorioamnionitis include maternal fever, uterine tenderness, purulent/foul-smelling amniotic fluid, maternal/fetal tachycardia. Common fetal complications of chorioamnionitis include preterm birth, neonatal sepsis, neurologic complications, respiratory complications. Common maternal complications of chorioamnionitis include maternal sepsis, infections, and Labor-related complications (e.g., cesarean section, postpartum hemorrhage, etc.)
Natural History
The symptoms of chorioamnionitis usually develop during the pregnancy, and start with symptoms such as maternal fever, uterine tenderness, purulent/foul-smelling amniotic fluid, maternal/fetal tachycardia.[1]
- The most important clinical finding among patients with chorioamnionitis is fever, and temperature > 100.4 F should be defined as abnormal during pregnancy.
- Although uterine tenderness is an important clinical finding, it might be challenging to differentiate uterine tenderness from the pain of the labor or conditions such as placental abruption. Also, the patient might not be able to feel the pain due to the effects of analgesics and anesthetic procedures.
- The presence of purulent/foul-smelling amniotic fluid depends on the responsible microorganism and the severity of the chorioamnionitis.
- Maternal tachycardia (>100 per minute) and fetal tachycardia (>160 per minute) are important and common clinical findings of chorioamnionitis.
Complications
Fetal complications that can develop as a result of chorioamnionitis are:[2][3]
- Preterm birth
- Retinopathy of prematurity
- Neonatal sepsis
- Neonatal death
- Neurologic complications
- Respiratory complications
Maternal complications that can develop as a result of chorioamnionitis are:[3][1]
- Maternal sepsis
- Infections
- Severe pelvic infections and abscess
- Wound infections
- Endomyometritis
- Labor-related complications
Prognosis
The presence of cesarean delivery for dystocia, prolonged labor times (≥ 10 h), or administration of oxytocin during labor are associated with a particularly poor prognosis among patients with chorioamnionitis.[4]
References
- ↑ 1.0 1.1 Tita AT, Andrews WW (June 2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.
- ↑ Ericson JE, Laughon MM (March 2015). "Chorioamnionitis: implications for the neonate". Clin Perinatol. 42 (1): 155–65, ix. doi:10.1016/j.clp.2014.10.011. PMC 4331454. PMID 25678002.
- ↑ 3.0 3.1 Fowler JR, Simon LV. PMID 30335284. Missing or empty
|title=(help) - ↑ Alexander JM, McIntire DM, Leveno KJ (August 1999). "Chorioamnionitis and the prognosis for term infants". Obstet Gynecol. 94 (2): 274–8. doi:10.1016/s0029-7844(99)00256-2. PMID 10432142.