chorioamnionitis

-Intra-amniotic infection (IAI, chorioamnionitis) is the infection of the amniotic fluid, membranes, placenta, umbilical cord, and/or decidua.

-The key criterion: Maternal fever

-The diagnosis of IAI is based on clinical findings: maternal fever, Baseline fetal heart rate >160 beats/min for ≥10 minutes, Maternal white cell count >15,000/mm³ , Purulent-appearing fluid coming from the cervical os visualized by speculum examination, positive Gram stain of amniotic fluid, Low glucose level in amniotic fluid, Positive amniotic fluid culture, High white cell (WBC) count in amniotic fluid, Histopathologic evidence of infection or inflammation or both in the placenta, fetal membranes, or the umbilical cord vessels

-Laboratory studies should be performed on amniotic fluid obtained by amniocentesis.

-Treatment: Antibiotics + Delivery. Treat with broad-spectrum antibiotics: ampicillin, gentamicin, ticarcillin-clavulanate, cefoxitin, cefotetan, piperacillin-tazobactam, ertapenem, vancomycin, clindamycin; Monitor fetus during delivery.

-Complications: perinatal death, asphyxia, early-onset neonatal sepsis, septic shock, pneumonia, meningitis, intraventricular hemorrhage, cerebral white matter damage, and long-term neurodevelopmental disability including cerebral palsy

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