Chorioamnionitis is a bacterial infection of the membranes (amnion and chorion) and amniotic fluid surrounding a fetus within the uterus. This condition is common in births where membranes rupture prematurely. It is, however, much more uncommon (up to 2% in the United States) in full-term births, and typically occurs in the later stages of pregnancy. The infection typically starts in the vagina, anus or rectum of the mother and moves up into the uterus.
When the membranes rupture and a long labor ensues, this leaves the vaginal canal open to the uterus and allows opportunity for bacteria (commonly Group B Streptococcus, GBS) to travel from the vagina into the uterus. It can lead to further complications such as blood clots in the pelvis and lungs of the mother and infections such as pneumonia of the fetus. Risk factors include compromised maternal immune system, obesity, use of internal monitoring devices and multiple (more than 4) vaginal exams during labor.
Patient (mother and fetus) will be free from infection, prevention of complications or fetal infection
Monitor maternal vital signs for fever or tachycardia that may indicate infection
Symptoms are similar to other diseases and must be monitored closely to prevent development of complications
Monitor fetal heart rate
Elevated fetal heart rate indicates a sign of distress. If the fetal heart rate increases, assess the mother for signs of infection.
Monitor diagnostic test results including white blood cell count and urinalysis
Assess and culture vaginal discharge, if present
Verify allergies and administer medications as necessary
Prepare patient for vaginal or c-section delivery if indicated
Advanced infection may require early termination of pregnancy. Depending on gestational age, patient may have induced labor or c-section delivery to prevent complications and fetal infection.
Encourage patient to rest as much as possible to promote healing and reduce fetal distress
Provide patient education for prevention of further infection
If membranes have ruptured, avoid tub or sitz bath to reduce bacterial exposure to the vagina and uterus.
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