Infant Chorioamnionitis
What is Infant Chorioamnionitis?
Chorioamnionitis is an inflammation of the fetal membranes due to a bacterial infection. It is often caught in the mother’s urogenital tract and works its way up towards the baby, infecting the fetal membranes, and causing a number of problems for both mother and baby.
If left untreated, the mother may develop pelvic or uterine infections, endometriosis, blood clots, and/or sepsis.
What Causes Infant Chorioamnionitis?
Maternal infection is the primary reason for developing chorioamnionitis, and it usually develops in the mother’s vaginal area. The bacteria that causes this kind of serious maternal infection includes anaerobic bacteria, E. coli, and group B streptococci. The mother should report these symptoms immediately and the doctor should treat these viruses as serious so that chorioamnionitis doesn’t develop.
Other risk factors include:
- Young maternal age, generally less than 21 years old
- First pregnancies
- Prolonged ruptured membranes
- A long, stressful labor
- Excessive fetal and/or uterine monitoring
What are the Symptoms of Infant Chorioamnionitis?
Because this particular birth injury affects an infant while still in utero, it is the mother that experiences the symptoms, which may include fever, fetal tachycardia, sometimes severe maternal tachycardia, maternal leukocytosis, purulent or foul-smelling amniotic fluid, vaginal discharge, or uterine tenderness.
Diagnosis of Chorioamnionitis
Although there are generally no outward symptoms with the mother, physicians can generally diagnose chorioamnionitis by checking for an increased heart rate in both mom and baby. However, according to the National Institutes of Health (NIH), maternal fever is one of the most prominent indications of chorioamniontitis. Mothers typically have a recurring fever of over 100 F, which is considered abnormal during pregnancy.
For infants, a diagnosis is generally made, based upon the following symptoms:
- Weak cries, poor sucking, and fatigue
- Pulmonary problems, such as respiratory distress, apnea, and cyanosis
- Gastrointestinal problems, which may include bloody stools, vomiting, and diarrhea
- Seizures
- Hematologic problems, such as pallor or purpura
During pregnancy, laboratory tests may be performed in order to check the mother’s blood, urine, and to rule out group B strep. In addition, the amniotic fluid is examined for abnormalities, bacterial culture, glucose concentration, gram straining, and pH levels.
Mothers may also be tested for:
- White blood cell counts
- Levels of C-reactive proteins
- Alpha1-protein measurement
- Ferritin levels
What is the Treatment for Chorioamnionitis?
Because chorioamnionitis is so dangerous, the treatment for the infant is generally a hasty delivery. In severe cases, infants may undergo surgery if the following conditions are present:
- Subcutaneous or brain abscess
- Infections around the pleural area
- Severe abdominal infections
- Bone and/or joint infections
In most cases, the mother is given antibiotics, and if needed, the infant may be prescribed antibiotics as well.
Other forms of treatment include:
- Infant intubation and ventilation
- Balancing glucose levels
- Artificial breathing tubes for the infant
Can Infant Chorioamnionitis Affect the My Baby After Birth?
If the infection is caught immediately and the infant is given antibiotics, the infant will usually not have any long-term effects to chorioamnionitis. However, if the infection is not immediately caught, the child’s side-effects could include sepsis (a dangerous infection in the blood), meningitis (an infection experienced in the lining of the spinal cord), and sometimes severe respiratory problems.
In some cases, an infant may develop pneumonia and/or brain complications. Infants who are born prematurely are at a heightened risks for developing these medical conditions, but the risk is still relatively rare, with an average 10-20% chance of developing pneumonia and a 15% chance of developing brain complications.