Chorioamnionitis

What it is

Chorioamnionitis is intrauterine infection, and in the PROM protocol it is the complication that rupture of the membranes is watched for. The most significant maternal risk of term PROM is intrauterine infection, and that risk increases with the duration of membrane rupture; the fetal risks named alongside it are umbilical cord compression and ascending infection. In preterm PROM the same infection matters for a second reason: women with intrauterine infection deliver earlier than non-infected women, and infants born with sepsis have mortality four times higher than those without sepsis.

How it is diagnosed

The protocol gives a set of signs to monitor for, and the same set is repeated in the in-utero transfer protocol, which is a useful check that you have the list right.

PROM protocol, signs of chorioamnionitis: pyrexia; tachycardia, maternal and fetal; leukocytosis; uterine tenderness; and offensive vaginal discharge.

In-utero transfer protocol, signs of chorioamnionitis: maternal pyrexia; maternal or fetal tachycardia; uterine tenderness; offensive liquor; and leucocytosis. The two lists are the same five items.

On the history side, the symptoms of infection asked about in a woman with ruptured membranes are fever, maternal tachycardia, and foul smelling vaginal discharge.