Throughout your pregnancy and the labor and delivery process, your provider and care team will be on the lookout for any complications that could potentially affect you or your baby.One complication that has the potential to affect both of you is known as chorioamnionitis. While rare, it’s important to know the signs and symptoms of chorioamnionitis (also known as an intraamniotic infection) to help protect you and your little one. Here’s what you should know about the causes, symptoms, and treatment of chorioamnionitis.
What Is Chorioamnionitis?
Chorioamnionitis occurs when an infection develops in the membranes of your uterus, known as the chorion and the amnion. Intraamniotic infections are caused by harmful bacteria introduced to these membranes, the amniotic fluid, or even the placenta during your pregnancy. While chorioamnionitis can happen at any point during pregnancy, the majority of cases are detected and treated during labor. The American College of Obstetrics and Gynecology estimates that clinically-apparent intraamniotic infection affects 2 to 5% of all full-term deliveries.
What Is the Main Cause of Chorioamnionitis?
Chorioamnionitis is caused by the introduction of bacteria (such as E.coli and group B strep) that leads to a bacterial infection. The infection can start outside of the uterus in the vagina, anus, or rectum, and spread into the uterus — or can even begin in the uterus if the amniotic sac tears or breaks (more commonly known as your water breaking).
The introduction of bacteria into the uterus can occur through external means, such as having too many vaginal exams after your water breaks, or even during certain invasive procedures like amniocentesis.
How Serious Is Chorioamnionitis?
If left untreated, chorioamnionitis can cause serious complications for you and your baby. And while we know that can be scary to hear, it’s important to remember your provider and care team will be on the lookout for this (and other) conditions to help keep you and your baby as safe as possible during your pregnancy and childbirth.
Complications of chorioamnionitis that can affect a pregnant woman include:
- Infections spreading to the abdomen or pelvic area
- Endometriosis
- Blood clots
- Sepsis (a serious blood infection)
- Increased interventions during birth
- Postpartum hemorrhage
- Respiratory distress syndrome
Complications of Chorioamnionitis for Newborn Babies:
- Sepsis
- Meningitis (inflammation of the brain and spinal cord)
- Pneumonia
What Are the Symptoms of Chorioamnionitis?
While symptoms of an intraamniotic infection can vary from person to person, common symptoms include:
- A fever or elevated temperature for the birthing person
- A rapid heart rate (in the fetus and/or the birthing person)
- Pain or tenderness in the uterus
- Unusual sweating
- Vaginal discharge with an unpleasant smell or unusual color
If your provider suspects you may have chorioamnionitis, they’ll begin with a physical exam and ask a variety of questions to understand your physical symptoms and medical history. Your provider may recommend some or all of the following steps to diagnose your condition and evaluate you and your baby’s health:
- Blood and/or urine test to evaluate white blood cell count and check for infection
- Amniotic fluid sample to detect bacteria (amniocentesis)
- A culture from the vagina to check for bacteria
- An ultrasound to evaluate your baby’s health
What Are the Risk Factors of Chorioamnionitis?
There are several conditions or scenarios that can increase a pregnant person’s chances of chorioamnionitis, including:
- A long time between their water breaking and delivery
- A lengthy labor
- Frequent vaginal exams or cervical checks during labor
- First childbirth experience
- Internal fetal monitoring
- Group B strep
- An STI or other vaginal infection
- Tobacco or alcohol use during their pregnancy
How is Chorioamnionitis Treated?
If your provider suspects or diagnoses you with chorioamnionitis, the first (and most important) step in treatment is to provide you with antibiotics to help fight the infection. Antibiotics are usually given via an IV directly into your veins, and can help protect both mama and baby against the infection.
If you aren’t already in labor when an intraamniotic infection is diagnosed, your provider may recommend an early delivery to keep you and your baby as safe and healthy as possible. Though an early delivery isn’t always necessary, in severe cases it can prevent serious health issues from persisting. It’s also important to note: a chorioamnionitis diagnosis is rarely a reason for an emergency C-section delivery.
In terms of treating a newborn directly for chorioamnionitis, it’s truly a case-by-case basis. Upon birth, baby’s care team will be informed about their possible exposure to an intraamniotic infection. They will keep a close eye on baby for signs of infection, and determine whether or not they need additional antibiotics. If your newborn requires treatment against infection, antibiotics will be administered via IV or injection.
If you think you are experiencing the symptoms of chorioamnionitis such as a fever, abdominal or pelvic pain, or a bad odor coming from your vaginal discharge, it’s important to contact your provider immediately. It’s also important to get in touch with your provider or call your provider’s emergency line if your water breaks.
Any complication during pregnancy or delivery can be scary. By being aware of unusual symptoms and communicating with your provider, you can help ensure a safe delivery for you and your baby.