What are the maternal clinical signs and symptoms in patients with chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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As noted earlier, the diagnosis of clinical maternal chorioamnionitis made on the basis of clinical findings of fever plus fetal tachycardia, maternal leukocytosis, or purulent fluid coming from the cervical os (see the table below). Affected women with chorioamnionitis may appear ill, even toxic, and they may exhibit hypotension, diaphoresis, and/or cool or clammy skin. However, maternal clinical signs or symptoms of infection may be absent, particularly when dealing with histologic chorioamnionitis (silent chorioamnionitis). [5]

Table. Features of Isolated Maternal Fever and Triple I with Classification. [141] (Open Table in a new window)

Terminology Features and Comments
Isolated Maternal Fever 


(“Documented” fever)

Maternal oral temperature ≥39.0°C (≥102.2°F) on any one occasion is documented fever. If the oral temperature is between 38.0°C (100.4°F) and 39.0°C (102.2°F), repeat the measurement in 30 minutes; if the repeat value remains at least 38.0°C (≥100.4°F), it is documented fever.

Suspected Triple I

Fever without a clear source plus any of the following:

  • Baseline fetal tachycardia (>160 beats per min for 10 min or longer, excluding accelerations, decelerations, and periods of marked variability)
  • Maternal white blood cell count >15,000 per mm 3 in the absence of corticosteroids
  • Definite purulent fluid from the cervical os

Confirmed Triple I

All of the above plus:

  • Amniocentesis-proven infection through a positive Gram stain
  • Low glucose level or positive amniotic fluid culture
  • Placental pathology revealing diagnostic features of infection

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