Chorioamnionitis

Question 1

What is chorioamnionitis?

Answer 1

Bacterial infection that affects the membranes surrounding the fetus and placenta (i.e. the amnion and chorion). It can expand and lead to both foetal and maternal sepsis.

Question 2

Whatt is the most common cause of chorioamnionitis?

Answer 2

Group B streptococcus

-> other microbes include E.coli, anaerobic bacteraemia and other polymicrobial infection

Question 3

What are the risk factors for chorioamnionitis infection?

Answer 3

*Pre-labour rupture of membranes (PROM) and *Pre-labour pre-term rupture of membranes (PPROM)
*Prolonged rupture of membranes (>18h)
*Prolonged labor
*Multiple vaginal examinations during labor
Internal monitoring devices (e.g. fpetal scalp electrode, intrauterine pressure catheter)
*Bacterial vaginosis or genital tract infections
*Nulliparity
*Young maternal age

Question 4

How does chorioamnionitis present?

Answer 4

*Maternal fever
*Abdominal pain
*Cervical tenderness
*Malodorous vaginal discharge
*Maternal tachycardia (over 100) and foetal tachycardia (over 160)

Question 5

What investigations to perform chorioamnionitis suspicion?

Answer 5

Culture for amniocentesis
Urine dip for microsocpy and culture
Abdominal examination
Speculum examiantion
Urine dip for MC to rule out UTI
CTBG mohntirohinbg for foetus

Question 6

When to avoid speculum examination?

Answer 6

contraindicated if known rupture of membranes (due to risk of ascending infection

Question 7

How to manage chorioamnionitis?

Answer 7

Hospital admission for Intravenous broad spectrum antibiotic therapy as part of the sepsis six protocol

Monitoring of mother and foetus

Early delivery only if evidence of foetal or maternal compromise

Question 8

Which antibiotics are given for chorioamnionitis?

Answer 8

gentamicin and ampicillin. - Others, such as clindamycin or metronidazole may be considered, especially if c-section is performed to cover anaerobic bacteria.

Question 9

What are the maternal com0ications of chorioamnionitis
?

Answer 9

Sepsis
Postpartum infections (e.g. endometritis)
Increased risk of cesarean delivery
Postpartum hemorrhage

Question 10

What are the foetal complications of chorioamnionitis?

Answer 10

Neonatal sepsis
Preterm birth
Respiratory distress syndrome
Neurological complications (e.g. cerebral palsy)
Stillbirth

Question 11

What is the first steps in the management of haemodynamic compromise in a pregnant woman?

Answer 11

Lie the patient on her left lateral side to relieve the pressure of the uterus on the inferior vena cava, increase venous return and improve circulation

Question 12

How long to give anifbigoics for preterm prelabour rupture of membranes?

Answer 12

10 days

Question 13

What to give for prevention of chorioamnionitis in preterm prelabour rupture of membranes?

Answer 13

10 days of oral erythromycin

Question 14

What does a hard and tense uterus indicate?

Answer 14

Placental abruption

Question 15

Which pathogens causes group B strep?

Answer 15

Streptococcus agalacticae