INFORMATION FOR WOMEN WHO HAVE CHORIOAMNIONITIS DURING PREGNANCY OR BREASTFEEDING
What is chorioamnionitis during pregnancy?
Chorioamnionitis also called an intraamniotic infection (IAI) or Intrauterine Infection and/or Inflammation (Triple-I), is inflammation of the fetal membranes, usually because of a bacterial infection. The fetal membranes consist of an outer membrane called the chorion, and an inner membrane called the amnion, which encloses the amniotic sac, contains clear, pale to yellow fluid called amniotic fluid, which supports and protects the fetus.
How common is chorioamnionitis during pregnancy?
Overall, chorioamnionitis complicates 1 of every 30 deliveries, but the prevalence of the condition increases as the gestational age of the newborn at delivery decreases. In other words, the more premature the delivery, the more common chorioamnionitis becomes. In fact, chorioamnionitis complicates as many as 4070% of preterm births.
How is chorioamnionitis during pregnancy diagnosed?
Chorioamnionitis is a clinical diagnosis. This means that diagnosis begins with a strong clinical suspicion by your obstetrician, based on signs and symptoms, such as fever, rapid heartbeat (tachycardia) in the mother and/or fetus, and discharge with pus from the cervix. Later, after delivery, doctors may order laboratory evaluation of the placenta and testing of amniotic fluid for bacteria. However, the diagnosis should be made before delivery, because antibiotic treatment should begin empirically, meaning based on the clinical picture without results of laboratory tests.
Does chorioamnionitis cause problems during pregnancy?
Chorioamnionitis causes fever and, very commonly, rupture of membranes, initiating labor, which is a problem if you are not yet at term. Additionally, it causes a need for a cesarean section, which can increase your recovery time and potential complications. If antibiotic treatment is started early, in some cases, it may be possible to attempt a vaginal delivery, but usually, a cesarean is the delivery method. Chorioamnionitis has a high rate of maternal and neonatal complications and death if it is not recognized quickly and treated with antibiotics.
Does chorioamnionitis cause problems for the baby?
Yes. In addition to causing rupture of membranes, which can initiate premature labor and birth, chorioamnionitis is associated with neonatal asphyxia (lack of oxygen, suffocation, in the newborn), and early-onset neonatal sepsis (EONS, infection throughout the newborn). Chorioamnionitis leads to long-term neurologic problems, including cerebral palsy. Overall, chorioamnionitis has a high rate of maternal and neonatal complications and death if it is not recognized quickly and treated with antibiotics.
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the chorioamnionitis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat chorioamnionitis during pregnancy?
It is absolutely vital to recognize chorioamnionitis early and to begin antibiotic treatment. Various antibiotic regimens are available that are considered fairly safe in pregnancy. Some of the antibiotics are given orally, some are given by injection, and a few are given intravenously or by suppository (into the rectum). Choices that are considered quite safe for the baby include different types of penicillin antibiotics, different types of cephalosporin antibiotics, certain macrolide antibiotics such as erythromycin and azithromycin, and various others such as clindamycin, nitrofurantoin, and spectinomycin.
Who should NOT stop taking medication for chorioamnionitis during pregnancy?
Antibiotic treatment must not be stopped, but if there is a problem with a particular antibiotic regimen (you suffer a reaction or side effects), your doctor can switch the regimen.
What should I know about choosing a medication for my chorioamnionitis during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for my chorioamnionitis when I am breastfeeding?
As with pregnancy, there are many choices of antibiotic regimens that are considered safe for nursing mothers.
What alternative therapies besides medications can I use to treat my chorioamnionitis during pregnancy?
There is no alternative to antibiotic therapy. However, surgical delivery of the newborn (cesarean delivery) is considered to be a big component of the treatment as it helps to prevent the neonatal complications associated with chorioamnionitis.
What can I do for myself and my baby when I have chorioamnionitis during pregnancy?
It is very important to follow the instructions of your physicians because chorioamnionitis is potentially fatal both to the mother and the baby.
Resources for chorioamnionitis in pregnancy:
For more information about chorioamnionitis during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations: