Chorioamnionitis is an infection within the womb which with reference to pregnancy means infection in the membranes or the amniotic fluid and also called intra-amniotic infection (IAI) and amnionitis. It is a serious condition during pregnancy but not life-threatening. The infection if not treated properly and on time can lead to complications for the expectant mother and the fetus.
In this article:
What is Chorioamnionitis?
What are the Causes of Chorioamnionitis?
What are the Risk Factors for Chorioamnionitis?
What are the Symptoms of Chorioamnionitis?
How is Chorioamnionitis Diagnosed?
What are the Complications of Chorioamnionitis?
How is Chorioamnionitis Treated?
Natural Remedies for Chorioamnionitis
How Can Chorioamnionitis be Prevented?
Frequently Asked Questions
All You Need to Know about Chorioamnionitis
What is Chorioamnionitis?
Chorioamnionitis is an inflammation of the fetal membrane (amnion and chorion) due to bacterial infection and affecting pregnant women that occurs before or during labor. Amnion (fluid-filled sac) and chorion (outer membrane) infection occurs when bacteria travel from the vagina to the uterus especially after the fetal membranes have ruptured and during labor. This can lead to infections in the mother as well as the fetus.
What are the Causes of Chorioamnionitis?
Chorioamnionitis usually develops because of an infection that occurs when bacteria that are normally present in the vagina ascend into the uterus where the fetal is located. E.coli, group B streptococci and anaerobic bacteria are known to be the most common causes. The amniotic fluid and placenta and baby can also carry infection.
What are the Risk Factors for Chorioamnionitis?
Chorioamnionitis include risk factors –
- Young maternal age (less than 21 years old)
- Low socioeconomic status
- First pregnancy
- Long labor
- Membranes that are ruptured (water has broken) for an extended period of time
- Premature birth
- Multiple vaginal examinations during labor (only a risk factor in women with ruptured membranes)
- Pre-existing infections of the lower genital tract
- Internal fetal or uterine monitoring
What are the Symptoms of Chorioamnionitis?
Chorioamnionitis doesn’t always cause symptoms but some woman may have –
- Fever
- Rapid heartbeat
- Uterine tenderness
- Discoloured, foul-smelling amniotic fluid
How is Chorioamnionitis Diagnosed?
The doctor can usually diagnose this condition by performing a physical examination. Laboratory tests can confirm that diagnosis. Amniocentesis may be necessary during preterm labor. During this prenatal test, a small amount of amniotic fluid is removed for testing.
What are the Complications of Chorioamnionitis?
Chorioamnionitis is usually considered a medical emergency which leads to complications like –
- Bacteremia (infection in the bloodstream)
- Endometritis (infection in the uterus lining)
- Need for cesarean delivery
- Heavy blood loss with delivery
- Blood clots in the lungs and pelvis
About 3 to 12 percent of women with chorioamnionitis have bacteremia and this condition also increases the need for cesarean delivery. Of those with cesarean delivery, up to 8 percent develop a wound infection and approximately 1 percent develop a pelvic abscess (collection pus). Maternal death due to infection is extremely rare.
Babies delivered to mothers with chorioamnionitis are also in danger of serious complications like –
- The condition can lead to meningitis
- Pneumonia or bacteremia may also develop
How is Chorioamnionitis Treated?
Early treatment can bring down the fever, shorten the recovery time and lower the baby’s risk of infection and complications. Antibiotics are commonly used to treat the condition usually given through an IV route and are continued until delivered to the baby. The antibiotics are –
- Ampicillin
- Penicillin
- Gentamicin
- Clindamycin
- Metronidazole
When the infection is responding to treatment, the doctor will stop administering antibiotics.
Natural Remedies for Chorioamnionitis
Chorioamnionitis being a critical condition should be treated using antibiotics prescribed by doctors, however, experienced midwives try natural home remedies to cure the infection which are –
- Raw garlic – mix 2-4 cloves of garlic and let it sit for some time so that the microbial compound allicin gets activated. Then simply add to the bowl of salad or could swallow it with a glass of water.
- Echinacea – the herb is absolutely safe during pregnancy which is believed to enhance and improve immunity thereby putting an end to infections.
- Astragalus – it is a Chinese tonic for immunity. It can be taken by putting in just one-two strips of the herb in the soup or rice while cooking. Remove the strips after the cooking is done.
- Apple cider vinegar bath – taking a bath with water in which 1/4th cup of ACV is added, thrice a week can keep all infections at bay.
- Probiotic diet – including fermented food like yogurt and curd in the daily diet proves to be beneficial in treating bacterial colonization.
How Can Chorioamnionitis be Prevented?
The doctor will make every effort to prevent the infection from developing in the first place which are –
- Screening for bacterial vaginosis (vaginal inflammation) in the second trimester
- Screening for group B streptococcal infection once reach 35 weeks to 37 weeks of pregnancy
- Reducing the number of vaginal examinations performed during labor
- Minimizing the frequency of internal monitoring
Frequently Asked Questions
What is the Long-Term Outlook of Chorioamnionitis?
The long-term outlook for mothers with chorioamnionitis is known to be excellent. Future fertility is rarely compromised. The outlook for infants delivered to infected mothers is also very good. But some babies, particularly the preterm, may have long-term complications. These complications can include lung disease and impaired brain function.
What are the Chances of Complications to Occur?
Complications are less likely to occur if the infection is diagnosed early and antibiotic treatment is started on time. Rarely, the complications associated with chorioamnionitis can be life-threatening to preterm infants.
Conclusion
Chorioamnionitis is quite common during pregnancy. It is important to attend regular check-ups with the doctor and address the questions and concerns towards having a good uneventful pregnancy and a healthy full-term baby.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008318/
- https://www.healthline.com/health/pregnancy/infections-chorioamnionitis#complications
