Intraamnial Infection

(Chorioamnionitis)

Intra-amniotic infection (formerly known as chorioamnionitis) is an infection of the chorion, amnion, amniotic fluid and / or placenta. The infection increases the risk of obstetric complications and problems in the fetus and newborn. Symptoms include fever, sensitivity of the uterus, foul-smelling vaginal discharge as well as maternal and fetal tachycardia. The diagnosis is made on the basis of specific clinical criteria or in subclinical infection by analysis of amniotic fluid. The treatment includes broad-spectrum antibiotics and childbirth.

An intra-amniotic infection typically starts with an infection that rises through the genital tract.

Intra-amniotic infection (formerly known as chorioamnionitis) is an infection of the chorion, amnion, amniotic fluid and / or placenta. The infection increases the risk of obstetric complications and problems in the fetus and newborn. Symptoms include fever, sensitivity of the uterus, foul-smelling vaginal discharge as well as maternal and fetal tachycardia. The diagnosis is made on the basis of specific clinical criteria or in subclinical infection by analysis of amniotic fluid. The treatment includes broad-spectrum antibiotics and childbirth. An intra-amniotic infection typically starts with an infection that rises through the genital tract. Risk factors include the following risk factors: Preterm labor childlessness meconium-stained amniotic fluid Internal fetal monitoring or uterine presence of pathogens in the genital tract (eg causing sexually transmitted diseases or bacterial vaginosis those, group B streptococci.) Multiple digital examinations during labor in women with ruptured membranes Lange birth Premature rupture in immature fetal complications a intraamnial infection can cause both a vorzeitger rupture in immature fetuses as well as a premature birth. These infections are responsible for 50% of births before the 30th week of pregnancy. They occur in 33% of women who have a premature birth with intact membranes, in 40% of women who have a premature rupture of membranes (PROM) and – if approved -‘re in labor, and 75% of women, which are the birth comes after instruction because of PROM. The fetal complications include an increased risk of these conditions: preterm APGAR score <3 Neonatal infection (eg, sepsis, pneumonia, meningitis.) Seizures cerebral palsy death Maternal complications include an increased risk of these conditions: bacteremia need for a cesarean uterine postpartum bleeding pelvic abscess thromboembolism wound complications septic shock, coagulation disorders and adult respiratory distress syndrome are also risks, but are to treat the infection rarely occur. Symptoms and signs A intraamnial infection typically causes fever. Other findings include maternal tachycardia, fetal tachycardia, sensitivity of the uterus and foul-smelling amniotic fluid and / or vaginal discharge. However, the infection does not cause typical symptoms (i. e. subclinical infection). Diagnosis Clinical criteria amniocentesis in cases of suspected subclinical infection Diagnosis maternal temperature usually requires> 38 ° C (> 100.4 ° F) plus ? 2 of the following criteria: Maternal WBC count> 15,000 cells / mm Maternal tachycardia (heart rate> 100 beats / minute) Fetal tachycardia (heart rate> 160 beats / minute) sensitivity of the uterus evil-smelling amniotic fluid or vaginal discharge presence of a single symptom or sign which may have a different cause, is less reliable. For example, pain and tenderness of the uterus by a placenta abruption can originate. Maternal tachycardia can occur because of pain, epidural or drugs (such as ephedrine.); fetal tachycardia may be the result of maternal medication or a fetal hypoxemia. The maternal and fetal heart rate be increased even with a fever. However, if no intra-amniotic infection that heart rates return to normal with recovery. If the fetal or maternal tachycardia is disproportionate or independently of such circumstances occurs or persists after improvement of the fact an intra-amniotic infection is assumed. Subclinical infection resistant premature labor (persistent despite tocolysis) might indicate a subclinical infection. If there is a rupture of the membranes before the deadline, should also be tested for subclinical infection, so that it can be ascertained whether induction of labor is indicated. Amniocentesis with the application of amniotic fluid culture is the most appropriate way to diagnose sub-clinical infection. The following amniotic findings indicate an infection out: presence of bacteria or leukocytes in the Gram staining Positive Culture glucose value <15 mg / dl WBC count> 30 cells / mm leukocyte values ??very low or higher Other diagnostic tests for subclinical infection are currently being investigated. Broad-spectrum antibiotic treatment plus delivery Treatment consists of broad-spectrum antibiotics iv plus delivery. A typical intrapartales antibiotic regimen is ampicillin 2 g iv every 6 hours plus gentamicin 1.5 mg / kg i.v. every 8 hours. The duration of antibiotic therapy depends (how high the fever for. Example, when the fever for the last time its maximum was related to childbirth) of individual factors. Antibiotics reduce the risk of morbidity due to infection for both mother and newborn. Prevention The risk of intraamnialen infection can be reduced by avoiding the digital vaginal examinations in women with premature rupture of membranes or minimized (Premature rupture (PROM)). Broad-spectrum antibiotics are given women with premature rupture of membranes, in order to prolong the latency until delivery and reduce the risk of morbidity and mortality of the infant. Summary A intraamnial infection can subclinical and relatively asymptomatic. The diagnosis should be considered in both fetal or maternal tachycardia or refractory premature birth, as well as women with typical symptoms of infection (eg., Fever, vaginal discharge, pain, tenderness) into consideration. In women with refractory premature delivery or premature rupture of an analysis and culture should be the amniotic fluid. An intra-amniotic infection should be treated with broad-spectrum antibiotics plus delivery.

Health Life Media Team

Leave a Reply