Overview
What the Diagnosis Means
Chorioamnionitis is the traditional clinical and pathological term for inflammation involving the amniotic fluid, membranes, placenta, or adjacent decidua.
Chorioamnionitis is the traditional clinical and pathological term for inflammation involving the amniotic fluid, membranes, placenta, or adjacent decidua. Current terminology often uses intraamniotic infection (IAI) or intrauterine inflammation, infection, or both because clinical inflammation does not prove that bacteria are present. Most acute cases begin when organisms ascend from the lower genital tract through the cervix and membranes into the amniotic cavity. The usual organisms include genital mycoplasmas such as Ureaplasma species and Mycoplasma hominis, along with organisms such as Gardnerella vaginalis, group B streptococcus, Lactobacillus, and Bacteroides. Infection is frequently polymicrobial. The inflammatory response can also be sterile, driven by alarmins or other danger signals; epidural-related fever is one important non-infectious look-alike. The distinction between maternal and fetal inflammation matters. Acute chorioamnionitis primarily describes the maternal neutrophilic response in the chorion and amnion. Inflammation in the umbilical cord, called funisitis, or fetal chorionic vasculitis indicates a fetal inflammatory response. Fetal inflammatory response syndrome, or FIRS, is associated with elevated fetal or cord plasma inflammatory markers such as interleukin-6 or C-reactive protein. A nurse should therefore treat a concerning...