Chorioamnionitis or Intra-Amniotic Infection (IAI) is an infection within the womb which with reference to pregnancy means infection in the membranes or the amniotic fluid. It is a serious condition in pregnant women but not life-threatening. The infection if not treated properly and on time can cause a lot of complications for the expectant mother and the fetus.
The complications can range from the mother giving birth to a pre-mature baby, heavy bleeding after delivery and several other health issues to the baby such as seizures and in extreme cases a lifelong disability.
Chorioamnionitis is an inflammation of the foetal membrane (Amnion and Chorion) due to bacterial infection. It affects pregnant women. Amnion and Chorio infection occurs when bacteria travel from the vagina to the uterus especially after the fetal membranes have ruptured and during labour. This can lead to infections in the mother as well as the foetus.
IAI during pregnancy is caused due to various reasons. They are:
Expectant mothers who are at risk of maternal chorioamnionitis are:
• Women who have never given birth before
• Who experience long hours of labour
• Who has ruptured her membrane when the baby is at a premature stage
• Have had a previous history of Chorioamnionitis
• Weak immunity due to poor nutrition and stress
• Have undergone multiple digital vaginal examinations under unhygienic conditions
• The Amniotic fluid is stained with meconium
• Having urogenital or cervical infections
• Intrauterine pressure catheters
• Sexually transmitted infection
• Who take alcohol or tobacco
Although the symptoms of Chorioamnionitis may not always be visible, some may have the following signs:
• Persistent high fever for more than an hour
• The mother’s heartbeat may be rapid along with the foetus’
• Sweating
• Vaginal discharge with a foul smell.
• Pain in the lower abdomen.
• Tender and painful uterus.
The diagnosis for IAI is essentially done by two methods –
• Having a fever (more than 100.4).
• Uterine tenderness.
• Checking for abnormal heartbeat (Tachycardia) of the expectant mother and the fetus.
• Foul smelling vaginal discharge.
Along with the presence of fever, any other two clinical symptoms are essential for diagnosis.
2. Pathological Diagnosis
Chorioamnionitis can cause a lot of complication on the mother, the fetus and the newborn. In case of severe infection, it can also prove to be fatal. Some of the complications of IAI are:
• Premature rupture of the amniotic sac
• High chances of cesarean birth
• Infection in the bloodstream of the mother
• Excessive bleeding after delivery due to haemorrhage
• Collection of pus around the uterus
• Clotting of blood in the legs of the mother
• The oxygen levels in the bloodstream of the foetus decrease
• Due to the chorio infection on the newborn, he may suffer from seizures
• Infection in the fetus may result in pneumonia and meningitis in the newborn
• The baby may be affected by lifelong disability due to disorders like Cerebral Palsy
Complications to the Mother
Complications to the Newborn
Chorioamnionitis can affect labour as well as the delivery of the baby. Below are some of the chorioamnionitis effects on the baby:
Immediate treatment of the infection in the mother can reduce the chances of complications and the baby from getting infected. Treatment includes –
1.Antibiotics:
Antibiotic interferes with the bacterial cell wall, making it difficult to multiply. All antibiotics should only be used as a last resort. Careless use may be counterproductive as the bacteria may develop drug resistance.
• Ampicillin
Most doctors prescribe this medication to patients suffering from chorioamnionitis.
• Clindamycin/Cephalosporin
There are cases where the patient is allergic to penicillin. Here, Clindamycin/Cephalosporin are given which also bactericidal properties.
• Cefotaxime
The WHO has mentioned this in their list of essential medicines because of it is highly effective. However, some patients may experience a common side effect which is swelling at the injection site. It is not recommended for patients allergic to penicillin.
• Erythromycin
It is sometimes used if the patient is allergic to penicillin. However, some doctors are sceptical of its performance.
2. Surgery
• Caesarean can be an option for quick delivery.
• Surgeries are conducted in case of brain abscess, subcutaneous abscess or bone/ joint infections.
3. Supportive Care (In Case Of Neonatal Sepsis)
Chorioamnionitis being critical in nature should be treated using antibiotics prescribed by doctors. However, experienced midwives try out natural home remedies to cure the infection. Let us learn about some of the herbal remedies for Chorioamnionitis in pregnancy.
• Raw Garlic
Mince 2-4 cloves of garlic and let it sit for some time so that the microbial compound allicin gets activated. Then simply add to your bowl of salad, or you could swallow it with a glass of water.
• Echinacea
The herb is absolutely safe during pregnancy. It is believed to enhance and improve immunity thereby putting an end to infections.
• Astragalus
It is a Chinese tonic for immunity. It can be taken by putting in just one-two strips of the herb in the soup or rice while cooking. Remove the strips after the cooking is done.
• Apple Cider Vinegar Bath
Taking a bath with water in which 1/4th cup of AVC is added, thrice a week, can keep all infections at bay.
• Probiotic Diet
Including fermented food like yoghurt and curd in your daily diet proves to be beneficial in treating bacterial colonization.
Chorioamnionitis in pregnancy can prove to be dangerous to the mother as well as the baby. Therefore doctors take every safety measure to make sure that the infection does not begin in the very first place. This can be done through several ways.
The severity of the infection and the pregnancy period in which it was first diagnosed plays a vital role in telling us the likely course of the disease. The complications will be less if the infection is contracted at the later stages of pregnancy than at the early stages. However with the advent of good facilities and professionals in the field of medicine, the future of treatment for Chorioamnionitis, looks bright.
Medical science has come a long way in treating infections like Chorioamnionitis and getting positive results in the process. However, it should be remembered that it is a dreaded condition which if left untreated could prove to be fatal to the mother as well as to the baby. Immediately consult your Gynaecologist/Obstetrician in case you experience any of the following symptoms during pregnancy.
Chorioamnionitis is quite common during pregnancy. Although not fatal in most cases, it could lead to serious consequences in some. Women with the said condition could lose their baby or even if their baby survived, it could suffer congenital disabilities and disorders. Therefore, being fully aware of the symptoms and consulting your doctor if you feel a hitch can be your first step towards having a good uneventful pregnancy and a healthy full term baby.