What is a Chorioamnionitis Infection?

CytomegalovirusA particularly severe infection of the membranes and amniotic fluid surrounding the baby, chorioamnionitis is sometimes used as a defense in cerebral palsy birth injury lawsuits.  Some doctors and hospitals will blame the baby’s injury on the infection, though it only occurs in 2% of United States births, and argue that lack of oxygen was not the cause.  Frequently, the defense is used in light of pathologic findings of chorioamnionitis (for example, pathology of the placenta) even though there are no clinical symptoms.

What Causes Chorioamnionitis?

Chorioamnionitis occurs when membranes rupture during labor. The bacteria from the lower genital tract are then able to ascend and begin to start infecting the outer layer of the amniotic sac.

Certain procedures such as cerclage and amniocentesis can increase the likelihood of chorioamnionitis to occur. However, the four most likely causes of chorioamnionitis are:

  1. When there has been a rupture of membranes for more than 8 hours.
  2. When the mother has a GBS, or Group B Streptococcus, infection
  3. When there are numerous or too many vaginal exams being conducted during the course of labor
  4. When there is internal monitoring of the baby

Symptoms and Diagnosis of Chorioamnionitis

Symptoms of chorioamnionitis include:

      • Maternal fever
      • Elevated maternal white blood count
      • Fetal tachycardia (fast heart rate)
      • Uterine tenderness

Diagnosis can be difficult even in the face of these symptoms, however (See Diagnosis and Management of Clinical Chorioamnionitis), Alan T. N. Tita, M.D., Ph.D.).  Many of these symptoms have other causes that must be excluded.  For example, maternal fever may be caused by patients who receive prostaglandins to induce labor, or patients who have epidurals.  Likewise, the white blood count naturally increases in pregnancy and even further with labor.  It can be associated with preterm and prolonged rupture of membranes (ROM).

If there is any doubt as to the diagnosis, an amniocentesis (removal of some amniotic fluid) can be performed, and the fluid can be cultured.  Not all hospitals perform those tests, however.

Complications Associated with Chorioamnionitis

Chorioamnionitis can cause injury to the mother and the baby. It is associated with fetal sepsis, premature birth, stillbirth, lung disease and cerebral palsy.

Treatment of Chorioamnionitis

If the symptoms exist without any other likely cause, physicians should immediately begin treatment.  The obstetrician’s course of action will depend on how far along the pregnancy is, and whether the baby requires more time in the womb.

There are only two treatments for chorioamnionitis.  Intravenous antibiotics should be used.  If the pregnancy is far enough along, the baby should be delivered by induction and vaginal delivery, or by cesarean section if the baby appears to be in any danger.

Contact us

If your pregnancy was complicated by infection, or if your child has cerebral palsy or other developmental delays, contact our birth injury malpractice attorneys at (855) 712-7818 or send us a confidential online communication.

For More Information

      1. When to Investigate and File a Claim for Birth Injury
      1. Birth Injury A to Z:  Medical and Legal Glossary
      1. Failure to Prevent, Diagnose or Treat

Photo by http://en.wikipedia.org/wiki/File:Chorioamnionitis_-_high_mag.jpg