Amnionitis

Amnionitis (chorioamnionitis, intraamniotic infection) is common, occurring in 1-5% of term deliveries and up to 25% of preterm deliveries. Amnionitis may be a causative factor in preterm births due to preterm labor or preterm premature rupture of membranes (PPROM). Amnionitis is polymicrobial infection and commonly involves bacteria that are part of the normal vaginal flora. In term patients, amnionitis seems to occur more as a consequence of multiple risk factors such as prolonged rupture of membranes or multiple vaginal examinations. The diagnosis of amnionitis is typically clinical and made based upon the presence of maternal fever and one of the following additional criteria: maternal tachycardia, fetal tachycardia, uterine tenderness, leukocytosis or foul-smelling vaginal discharge. Once the diagnosis of amnionitis is made either clinically or by amniocentesis, preparations for delivery should be undertaken. Additionally, given that amnionitis is polymicrobial in nature, broad-spectrum antibiotics should be initiated.