Which features of labor and delivery are associated with chorioamnionitis?

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

A retrospective study (2012-2015) suggests that prolonged spontaneous active labor beyond the median not only significantly raises the risk of chorioamnionitis but also increases the odds of cesarean delivery. [65]

In a report of patients with clinical signs and symptoms of chorioamnionitis at term, and using both cultivation and molecular techniques of amniotic fluid, investigators noted almost 40% of women clinically diagnosed with chorioamnionitis did not have any evidence of bacteria in the amniotic cavity. [66] Additionally, nearly 50% did not have evidence of acute inflammatory lesions of the placenta (ie, histologic chorioamnionitis). Thus, other causes of signs and symptoms that resemble maternal chorioamnionitis must be sought.

Epidural anesthesia during labor is associated with maternal fever [67] and fetal tachycardia (see Special Concerns in the Diagnostic Considerations section). A sterile inflammatory response in the placenta and the fetus has been shown to be associated with epidural-related maternal fever. [68] Other conditions, such as dehydration or maternal exhaustion during labor, may result in maternal fever and must also be considered as causes of the febrile state.


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