What are the signs and symptoms of chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Answer

The characteristic clinical signs and symptoms of chorioamnionitis include the following:

  • Maternal fever (intrapartum temperature >100.4°F or >38.0°C). [1] Other observed signs include the following [2] :

  • Baseline fetal tachycardia (>160 beats per min for 10 min or longer, excluding accelerations, decelerations, and periods of marked variability)

  • Maternal leukocytosis (total blood leukocyte count >15,000 cells/μL) in the absence of corticosteroids

  • Definite purulent fluid from the cervical os

  • Other nonspecific signs such as maternal tachycardia and uterine tenderness are deemphasized by a report from a workshop conducted by the National Institute of Child Health and Human Development (NICHD). [2]

The NICHD workshop recommended using the term “triple I” to address the heterogeneity of this disorder. The term "triple I" refers to intrauterine infection or inflammation or both, and it is defined by strict diagnostic criteria (see below); however, this terminology has not been universally accepted. [3] It is important to differentiate between clinical and histologic chorioamnionitis; the latter tend to be “silent” and present only with preterm labor or preterm premature rupture of membranes (PPROM). The risk of neonatal sepsis is increased when chorioamnionitis is diagnosed in the laboring mother; however, the risk is much lower than anticipated based on historical figures when widespread use of intrapartum antibiotics was not a common practice. [4]

See Presentation for more detail.


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