Chorioamnionitis

What is chorioamnionitis?

Chorioamnionitis (intra-amniotic infection) is a serious infection that affects a person during pregnancy. It gets its name from the two membranes that surround a fetus in your uterus: the chorion and the amnion.

This infection occurs when bacteria enter any of the tissues or membranes around a fetus. This includes:

• Chorion (outer membrane).
• Amnion (inner membrane).
• Placenta.
• Amniotic fluid.

Treatment usually involves antibiotics, but it may also mean your pregnancy care provider delivers your baby early. It can lead to life-threatening complications in both you and your baby if it’s left untreated.

How common is this condition?

Chorioamnionitis occurs in about 1% to 5% of births in the United States and is one of the causes of premature labor and delivery.

What are the signs and symptoms of chorioamnionitis?

Symptoms of chorioamnionitis vary. Some of the most common are:

• Fever.
• You or the fetus has a rapid heart rate.
• Tender or painful uterus.
• Vaginal discharge that has an unpleasant smell or unusual color.
• Sweating.

What causes chorioamnionitis in pregnancy?

A bacterial infection causes chorioamnionitis. The infection can start in your vagina, anus or rectum and spread up to your uterus. Conversely, it can begin in your uterus if the amniotic sac ruptures or tears. The bacteria can infect your placenta or the fetus.

Infection can also spread if you have too many vaginal exams after your water breaks or after a procedure like amniocentesis.

The most common bacteria that cause chorioamnionitis are E.coli and group B strep.

Can chorioamnionitis affect the fetus?

Yes, chorioamnionitis can affect the fetus. Some of the complications include severe infection and brain or lung problems.

How is chorioamnionitis diagnosed?

Your pregnancy care provider diagnoses chorioamnionitis with a physical exam and discussion of your symptoms and health history. They may also:

• Order a blood and urine test to check for infection or white blood cell count.
• Order a vaginal culture to look for bacteria.
• Take a sample of your amniotic fluid to look for bacteria.
• Perform an ultrasound to check on the health of the fetus.

How is chorioamnionitis treated?

If your provider diagnoses chorioamnionitis, they’ll give you antibiotics to help treat the infection. Antibiotics are typically given through an IV (medication through a needle directly into your vein).

In some cases, providers recommend an early delivery. This can prevent additional issues for you and your baby. If your newborn baby has an infection, they will be given antibiotics as well.

What are the complications of chorioamnionitis?

If you have a serious case of chorioamnionitis or if it goes untreated, some of the complications include:

• Infections in your pelvic region and abdomen.
• Endometritis.
• Blood clots in your pelvis or lungs.
• Sepsis (a life-threatening blood infection).

Your newborn baby could also have complications from a bacterial infection, including:

• Sepsis (a serious blood infection).
• Meningitis (brain and spinal cord inflammation).
• Pneumonia (lung infection).

What are the risk factors for chorioamnionitis?

Certain factors might create a higher risk for chorioamnionitis, including:

• Premature labor.
• Your water breaks more than 24 hours before delivery.
• You have a long labor.
• You have a vaginal infection or a sexually transmitted infection (STI).
• You have group B strep.
• You have frequent vaginal exams after your water breaks.
• Internal fetal or uterine monitoring.

How is chorioamnionitis prevented?

While some factors are out of your control, there are a few things you could do to reduce your risk of chorioamnionitis. These include:

• Taking antibiotics if your water breaks early.
• Limiting the number of vaginal exams after your water breaks.
• Getting screened for group B strep in your third trimester.

If you’re concerned about chorioamnionitis, ask your pregnancy provider about your risk of developing the condition so they can evaluate your situation.

When should I call my provider?

Call your pregnancy care provider if your membranes rupture (water breaks). You should also call them if you:

• Have a fever.
• Have abdominal or pelvic pain.
• Notice a bad smell coming from your vaginal discharge.

Can a baby survive in the womb without amniotic fluid?

No, a fetus can’t survive without amniotic fluid. Amniotic fluid plays an important role in protecting the fetus. Without it, the fetus is susceptible to infection as well as other life-threatening complications. Your provider will decide when it’s best to deliver the fetus depending on how far along your pregnancy is.

How long can my baby survive after my water breaks?

Each situation is different, but generally, most providers want to deliver your baby within 24 hours of your water breaking.

A note from Cleveland Clinic

Chorioamnionitis is a serious condition during pregnancy. While you may not be able to control it, there are some things you can do like recognize signs of the condition and share all of your pregnancy symptoms with your pregnancy care provider. Treatment typically involves antibiotics, but it may also mean your baby will be born early. Discuss your diagnosis with your provider and be sure to ask any questions you have.