Chorioamnionitis

Chorioamnionitis
Chorioamnionitis
	Micrograph showing acute chorioamnionitis, with neutrophils in the chorion. Also seen are fibrin thrombi, which indicate a severe fetal inflammatory response. H&E stain.
Specialty	Obstetrics and gynaecology

Chorioamnionitis, also known as intra-amniotic infection (IAI), is inflammation of the fetal membranes (amnion and chorion), usually due to bacterial infection.^[1] In 2015, a National Institute of Child Health and Human Development Workshop expert panel recommended use of the term "triple I" to address the heterogeneity of this disorder. The term triple I refers to intrauterine infection or inflammation or both and is defined by strict diagnostic criteria, but this terminology has not been commonly adopted although the criteria are used.^[2]

Chorioamnionitis results from an infection caused by bacteria ascending from the vagina into the uterus and is associated with premature or prolonged labor.^[3] It triggers an inflammatory response to release various inflammatory signaling molecules, leading to increased prostaglandin and metalloproteinase release. These substances promote uterine contractions and cervical ripening, causations of premature birth.^[4] The risk of developing chorioamnionitis increases with number of vaginal examinations performed in the final month of pregnancy, including labor.^[5]^[6] Tobacco and alcohol use also puts mothers at risk for chorioamnionitis development.^[7]

Chorioamnionitis is caught early by looking at signs and symptoms such as fever, abdominal pain, or abnormal vaginal excretion.^[8] Administration of antibiotics if the amniotic sac bursts prematurely can prevent chorioamnionitis occurrence.^[9]

^ ^a ^b Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM (October 2015). "Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance". American Journal of Obstetrics and Gynecology. 213 (4 Suppl): S29–S52. doi:10.1016/j.ajog.2015.08.040. PMC 4774647. PMID 26428501.
^ Tita AT (2019). Berghella V, Barss BA (eds.). "Intra-amniotic infection (clinical chorioamnionitis or triple I)". UpToDate.
^ Cheng YW, Delaney SS, Hopkins LM, Caughey AB (November 2009). "The association between the length of first stage of labor, mode of delivery, and perinatal outcomes in women undergoing induction of labor". American Journal of Obstetrics and Gynecology. 201 (5): 477.e1–477.e7. doi:10.1016/j.ajog.2009.05.024. PMID 19608153.
^ Cite error: The named reference :0 was invoked but never defined (see the help page).
^ Seaward PG, Hannah ME, Myhr TL, Farine D, Ohlsson A, Wang EE, et al. (November 1997). "International Multicentre Term Prelabor Rupture of Membranes Study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term". American Journal of Obstetrics and Gynecology. 177 (5): 1024–1029. doi:10.1016/s0002-9378(97)70007-3. PMID 9396886.
^ Gluck O, Mizrachi Y, Ganer Herman H, Bar J, Kovo M, Weiner E (April 2020). "The correlation between the number of vaginal examinations during active labor and febrile morbidity, a retrospective cohort study". BMC Pregnancy and Childbirth. 20 (1): 246. doi:10.1186/s12884-020-02925-9. PMC 7183634. PMID 32334543.
^ Sweeney EL, Dando SJ, Kallapur SG, Knox CL (January 2017). "The Human Ureaplasma Species as Causative Agents of Chorioamnionitis". Clinical Microbiology Reviews. 30 (1): 349–379. doi:10.1128/CMR.00091-16. PMC 5217797. PMID 27974410.
^ Cite error: The named reference Fowler_2019 was invoked but never defined (see the help page).
^ Cite error: The named reference Ericson_2015 was invoked but never defined (see the help page).

[Kim_2015-1] Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM (October 2015). "Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance". American Journal of Obstetrics and Gynecology. 213 (4 Suppl): S29–S52. doi:10.1016/j.ajog.2015.08.040. PMC 4774647. PMID 26428501.

[Tita_2019-2] Tita AT (2019). Berghella V, Barss BA (eds.). "Intra-amniotic infection (clinical chorioamnionitis or triple I)". UpToDate.

[Cheng_2009-3] Cheng YW, Delaney SS, Hopkins LM, Caughey AB (November 2009). "The association between the length of first stage of labor, mode of delivery, and perinatal outcomes in women undergoing induction of labor". American Journal of Obstetrics and Gynecology. 201 (5): 477.e1–477.e7. doi:10.1016/j.ajog.2009.05.024. PMID 19608153.

[:0-4] Cite error: The named reference :0 was invoked but never defined (see the help page).

[Seaward_1997-5] Seaward PG, Hannah ME, Myhr TL, Farine D, Ohlsson A, Wang EE, et al. (November 1997). "International Multicentre Term Prelabor Rupture of Membranes Study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term". American Journal of Obstetrics and Gynecology. 177 (5): 1024–1029. doi:10.1016/s0002-9378(97)70007-3. PMID 9396886.

[6] Gluck O, Mizrachi Y, Ganer Herman H, Bar J, Kovo M, Weiner E (April 2020). "The correlation between the number of vaginal examinations during active labor and febrile morbidity, a retrospective cohort study". BMC Pregnancy and Childbirth. 20 (1): 246. doi:10.1186/s12884-020-02925-9. PMC 7183634. PMID 32334543.

[Sweeney_2017-7] Sweeney EL, Dando SJ, Kallapur SG, Knox CL (January 2017). "The Human Ureaplasma Species as Causative Agents of Chorioamnionitis". Clinical Microbiology Reviews. 30 (1): 349–379. doi:10.1128/CMR.00091-16. PMC 5217797. PMID 27974410.

[Fowler_2019-8] Cite error: The named reference Fowler_2019 was invoked but never defined (see the help page).

[Ericson_2015-9] Cite error: The named reference Ericson_2015 was invoked but never defined (see the help page).

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