Chorioamnionitis at Term: Definition, Diagnosis, and Implications for Practice

J Perinat Neonatal Nurs. 2016 Apr-Jun;30(2):106-14. doi: 10.1097/JPN.0000000000000163.

Abstract

Chorioamnionitis is a serious complication during labor at term and is associated with adverse neonatal outcome affecting approximately 10% of pregnancies. It is diagnosed clinically or microbiologically or by histopathologic examination of the placenta and umbilical cord. The clinical criteria for chorioamnionitis found in preterm or term women include maternal fever combined with 2 or more findings of maternal tachycardia, fetal tachycardia, leukocytosis, uterine tenderness, and/or malodorous amniotic fluid. These subjective findings are neither sensitive nor specific. However, clinical chorioamnionitis requires a high index of suspicion, timely diagnosis, prompt antibiotic treatment, and delivery, which may help reduce the potentially devastating outcome of maternal and neonatal infections. This article focuses on clinical chorioamnionitis and presents the physiologic immune response during pregnancy, the definition of chorioamnionitis, clinical diagnostic criteria, and implications for practice.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Chorioamnionitis* / diagnosis
  • Chorioamnionitis* / nursing
  • Chorioamnionitis* / therapy
  • Disease Management
  • Early Diagnosis
  • Female
  • Fetal Diseases* / diagnosis
  • Fetal Diseases* / etiology
  • Fetal Diseases* / nursing
  • Fetal Diseases* / therapy
  • Humans
  • Infant, Newborn
  • Obstetric Labor Complications* / diagnosis
  • Obstetric Labor Complications* / nursing
  • Obstetric Labor Complications* / therapy
  • Placenta / microbiology
  • Placenta / pathology
  • Pregnancy
  • Pregnancy Outcome
  • Symptom Assessment / methods

Substances

  • Anti-Bacterial Agents