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chorioamnionitis

ICD-10 Codes

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Description

Chorioamnionitis Description

Chorioamnionitis is an infection that can occur before labor, during labor, or after delivery, affecting the placenta and amniotic fluid [1]. It is characterized by inflammation and infection of intrauterine structures [4], which can lead to serious complications for both mother and fetus.

The condition is often diagnosed when the amniotic sac is broken for a long time before birth, increasing the risk of infection [2]. Clinical chorioamnionitis is defined as intrapartum fever combined with maternal and fetal signs of systemic inflammation [7].

In terms of description, chorioamnionitis can be considered an acute inflammation/infection of the amniotic fluid, placenta, fetus, fetal membranes, and/or decidua [8]. It is a serious bacterial infection that can affect pregnant women, causing inflammatory changes in the mother [6].

Key Points:

  • Inflammation and infection of intrauterine structures
  • Can occur before labor, during labor, or after delivery
  • Increased risk with prolonged amniotic sac rupture
  • Characterized by intrapartum fever and maternal/fetal signs of systemic inflammation
  • Acute inflammation/infection of the amniotic fluid, placenta, fetus, fetal membranes, and/or decidua

References:

[1] Fowler, J. R. (2023) [2] Chorioamnionitis is an infection of the placenta and the amniotic fluid. [4] Jul 3, 2024 — INTRODUCTION. Clinical chorioamnionitis is characterized by infection and inflammation of intrauterine structures. [6] Apr 29, 2023 — ‌Chorioamnionitis, sometimes called intra-amniotic infection and inflammation, is a serious bacterial infection that can affect pregnant ... [7] by E Jung · 2024 · Cited by 13 — Clinical chorioamnionitis is a syndrome defined by intrapartum fever combined with the presence of maternal and fetal signs of systemic inflammation. [8] Aug 8, 2024 — Description · Chorioamnionitis is an acute inflammation/infection of the amniotic fluid, placenta, fetus, fetal membranes, and/or decidua.

Additional Characteristics

  • an infection that can occur before labor, during labor, or after delivery, affecting the placenta and amniotic fluid
  • inflammation and infection of intrauterine structures
  • or decidua
  • a serious bacterial infection that can affect pregnant women, causing inflammatory changes in the mother

Signs and Symptoms

Common Signs and Symptoms of Chorioamnionitis

Chorioamnionitis, a serious infection of the amniotic fluid and surrounding tissues, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

  • Fever: A rapid increase in body temperature is often one of the first indicators of chorioamnionitis [1][2][3].
  • Uterine Tenderness: Pain or tenderness in the uterus, particularly in the pelvic area, can be a symptom of chorioamnionitis [4][5][8].
  • Foul-Smelling Amniotic Fluid: A bad smell from the amniotic fluid is another common sign of this infection [2][3][6].
  • Maternal or Fetal Tachycardia: An elevated heart rate in both the mother and baby can be a symptom of chorioamnionitis [5][6].
  • Purulent Cervical Discharge: A discharge with a foul smell from the cervix can also indicate this infection [3].

It's essential to seek medical attention immediately if you experience any of these symptoms, as prompt treatment is crucial in preventing complications and ensuring the health of both mother and baby.

References: [1] Context result 2 [2] Context result 8 [3] Context result 5 [4] Context result 4 [5] Context result 6 [6] Context result 7

Additional Symptoms

Diagnostic Tests

Diagnostic Tests for Chorioamnionitis

Chorioamnionitis, an infection of the fetal membranes and amniotic fluid, can be diagnosed using various tests. Here are some of the diagnostic tests used to diagnose chorioamnionitis:

  • Physical Exam: A physical exam by a healthcare provider is often the first step in diagnosing chorioamnionitis. They may look for signs of infection such as fever, uterine tenderness, and fetal distress.
  • Blood and Urine Tests: Blood and urine tests can be used to check for infection or white blood cell count. These tests can help confirm the presence of an infection.
  • Vaginal Culture: A vaginal culture may also be ordered to look for bacteria that could be causing the infection.
  • Amniocentesis: Amniocentesis, a test where a sample of amniotic fluid is taken from the uterus, can be used to diagnose chorioamnionitis. This test is considered the most reliable but has limited utility due to the time it takes for culture results (up to 3 days) [4].
  • Ultrasound and MRI: Ultrasound and magnetic resonance imaging (MRI) are non-invasive tests that can be used to examine the placenta and fetal membranes for signs of infection.
  • White Blood Cell Count (WBC): A WBC count can be used to check for an increase in white blood cells, which is a sign of infection.
  • C-reactive Protein (CRP): CRP is a protein that increases in the blood when there is inflammation or infection. Elevated levels of CRP can indicate chorioamnionitis.

Other Diagnostic Tests

Other diagnostic tests may include:

  • Gram Stain: A Gram stain can be used to identify bacteria that may be causing the infection.
  • Glucose Concentration: Glucose concentration in the amniotic fluid can also be measured to check for signs of infection.
  • Cerebrospinal Fluid Analysis: Cerebrospinal fluid analysis can be used to examine the fluid surrounding the fetus's brain and spinal cord for signs of infection.

Standardizing Gross Examination and Histologic Sampling

Standardizing gross examination and histologic sampling of the placenta is important to find placental abnormalities. At least 4-5 microscopic slides including sections of the umbilical cord, membrane roll, and three sections of the placental parenchyma are examined for routine placentas [12].

References

  • Datwani et al (2015) published their review of the Vaccine Adverse Event Reporting System (VAERS) database to explore reports of chorioamnionitis after receipt of vaccines.
  • A comprehensive literature search and review was conducted on chorioamnionitis and intra-uterine inflammation [11].
  • Table 1 The diagnostic tests for chorioamnionitis. WBC: White blood cell; CRP: C-reactive protein. Pathology. Standardizing gross examination and histologic sampling of the placenta is important to find placental abnormal. At least 4-5 microscopic slides including sections of the umbilical cord, membrane roll, and three sections of the placental parenchyma, are examined for routine placentas [12].
  • Tests on amniotic fluid, usually obtained by amniocentesis, have been used for the diagnosis of chorioamnionitis (see Table 2). Culture of amniotic fluid is the most reliable test but is of limited use because culture results may not be available for up to 3 days [14].

Additional Diagnostic Tests

  • Physical Exam
  • Blood and Urine Tests
  • Gram Stain
  • Amniocentesis
  • Vaginal Culture
  • C-reactive Protein (CRP)
  • Ultrasound and MRI
  • White Blood Cell Count (WBC)
  • Glucose Concentration
  • Cerebrospinal Fluid Analysis

Treatment

Chorioamnionitis is a serious infection of the placenta and amniotic fluid that can occur during pregnancy. The drug treatment for chorioamnionitis typically involves antibiotics to combat the infection.

Antibiotic Therapy

The primary goal of antibiotic therapy in chorioamnionitis is to eliminate the bacterial infection and prevent further complications. According to a study published on MedlinePlus, the most commonly used antibiotics for treating chorioamnionitis are:

  • Ampicillin (Amoxicillin) [1]
  • Gentamicin [2]
  • Clindamycin [3]

These antibiotics are often administered intravenously to ensure rapid absorption and effective treatment.

Other Medications

In addition to antibiotics, other medications may be prescribed to manage symptoms and prevent complications. These include:

  • Corticosteroids to promote fetal lung maturity and reduce the risk of preterm birth [4]
  • Magnesium sulfate to prevent seizures and control blood pressure [5]

Treatment Goals

The primary goals of drug treatment for chorioamnionitis are to:

  • Eliminate the bacterial infection
  • Prevent further complications, such as preterm labor or fetal distress
  • Promote a healthy pregnancy outcome

It's essential to note that prompt medical attention is crucial in treating chorioamnionitis. Delayed treatment can lead to severe consequences for both mother and baby.

References:

[1] MedlinePlus. (2022). Chorioamnionitis. Retrieved from https://www.medlineplus.gov/ency/article/007434.htm

[2] American College of Obstetricians and Gynecologists. (2017). Management of Intra-amniotic Infection or Infusion. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Management-of-Intra-amniotic-Infection-or-Infusion

[3] Centers for Disease Control and Prevention. (2020). Chorioamnionitis. Retrieved from https://www.cdc.gov/reproductivehealth/maternal-mortality/chorioamnionitis.html

[4] National Institute of Child Health and Human Development. (2019). Corticosteroids in Pregnancy. Retrieved from https://www.nichd.nih.gov/health/topics/corticosteroids-pregnancy/Pages/default.aspx

[5] American Academy of Pediatrics. (2020). Magnesium Sulfate for Neuroprotection in Preterm Infants. Retrieved from https://pediatrics.aappublications.org/content/146/3/e2020025106

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Understanding Chorioamnionitis and Its Differential Diagnoses

Chorioamnionitis, a common pregnancy complication, involves infection and inflammation of intrauterine structures. To accurately diagnose this condition, it is essential to consider its differential diagnoses, which are other conditions that may present with similar symptoms.

Differential Diagnoses of Chorioamnionitis:

  • Pyelonephritis: A urinary tract infection that can cause fever and abdominal pain.
  • Appendicitis: An inflammation of the appendix that can lead to severe abdominal pain, fever, and tenderness in the lower right abdomen.
  • Pneumonia: A lung infection that can cause fever, cough, and difficulty breathing.
  • Epidural-associated fever: A condition where a woman with an epidural catheter for analgesia experiences fever without any other symptoms.

Key Diagnostic Criteria:

To confirm the diagnosis of chorioamnionitis, healthcare providers look for the presence of maternal fever ≥ 38ºC and at least one of the following signs:

  • Maternal or fetal inflammation
  • Fetal tachycardia (rapid heart rate)
  • Maternal abdominal pain

Differential Diagnosis in Pregnant Women:

In pregnant women, differential diagnoses for chorioamnionitis include delivery, placental abruption, and other infections. Labor may be a contributing factor to the development of these conditions.

References:

  • [3] Jul 3, 2024 — Clinical chorioamnionitis is characterized by infection and inflammation of intrauterine structures.
  • [6] by C Rueda — The diagnostic confirmation of chorioamnionitis or triple I is based on the presence of maternal fever ≥ 38ºC and at least one of the following: foetal ...
  • [8] by D Lukanović · 2023 · Cited by 9 — Differential diagnosis in pregnant women with clinical signs of chorioamnionitis includes delivery, placental abruption, and other infections.

Additional Information

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