Diagnosis and management of clinical chorioamnionitis

Clinics in Perinatology

Volumn 37, Issue 2, 2010, Pages 339-354

  Tita, Alan T N ^a   Andrews, William W ^a  

^a Division of Maternal Fetal Medicine   (United States)

Author keywords

Chorioamnionitis; Infection; Management; Pregnancy

Indexed keywords

AMOXICILLIN PLUS CLAVULANIC ACID; AMPICILLIN; AZITHROMYCIN; C REACTIVE PROTEIN; CLINDAMYCIN; ERYTHROMYCIN; GENTAMICIN; INTERCELLULAR ADHESION MOLECULE 1; INTERLEUKIN 6; LIPOPOLYSACCHARIDE BINDING PROTEIN; METRONIDAZOLE; PARACETAMOL; SULTAMICILLIN;

AMNIOCENTESIS; AMNION FLUID ANALYSIS; BACTEREMIA; BACTERIUM CULTURE; BLOOD CELL COUNT; BRAIN INJURY; CEREBRAL PALSY; CESAREAN SECTION; CHORIOAMNIONITIS; CHRONIC LUNG DISEASE; CLINICAL FEATURE; CLINICAL TRIAL; ENDOMETRIOSIS; ESCHERICHIA COLI; FEVER; GARDNERELLA VAGINALIS; HISTOPATHOLOGY; HUMAN; INCIDENCE; MEDICAL RESEARCH; MYCOPLASMA HOMINIS; NEUROLOGIC DISEASE; NEWBORN MORBIDITY; NEWBORN SEPSIS; PATHOGENESIS; PELVIS ABSCESS; POSTPARTUM HEMORRHAGE; PREGNANCY; PREGNANCY OUTCOME; PREMATURITY; PRIORITY JOURNAL; PUERPERAL INFECTION; REVIEW; RISK FACTOR; SEPSIS; STILLBIRTH; STREPTOCOCCUS AGALACTIAE; SYSTEMIC INFLAMMATORY RESPONSE SYNDROME; TACHYCARDIA; UREAPLASMA UREALYTICUM; WOUND INFECTION; DIFFERENTIAL DIAGNOSIS; FEMALE; MICROBIOLOGY; NEWBORN; PREGNANCY COMPLICATIONS, INFECTIOUS;

CHORIOAMNIONITIS; DIAGNOSIS, DIFFERENTIAL; FEMALE; HUMANS; INFANT, NEWBORN; PREGNANCY; PREGNANCY COMPLICATIONS, INFECTIOUS; PREGNANCY OUTCOME; RISK FACTORS;

EID: 77953510768     PISSN: 00955108     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.clp.2010.02.003     Document Type: Review

References (100)

1. Eschenbach D.A. Ureaplasma urealyticum and premature birth. Clin Infect Dis 1993, 17(Suppl 1):S100-S106.
2. Gibbs R.S., Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol 1991, 164:1317.
3. Soper D.E., Mayhall C.G., Dalton H.P. Risk factors for intraamniotic infection: a prospective epidemiologic study. Am J Obstet Gynecol 1989, 161:562.
4. Newton E.R. Chorioamnionitis and intraamniotic infection. Clin Obstet Gynecol 1993, 36:795.
5. Newton E.R., Prihoda T.J., Gibbs R.S. Logistic regression analysis of risk factors for intra-amniotic infection. Obstet Gynecol 1989, 73:571.
6. Piper J.M., Newton E.R., Berkus M.D., et al. Meconium: a marker for peripartum infection. Obstet Gynecol 1998, 91:741.
7. Tran S.H., Caughey A.B., Musci T.J. Meconium-stained amniotic fluid is associated with puerperal infections. Am J Obstet Gynecol 2003, 189:746.
8. Yoon B.H., Romero R., Moon J.B., et al. Clinical significance of intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Obstet Gynecol 2001, 185(5):1130-1136.
9. Alexander J.M., McIntire D.M., Leveno K.J. Chorioamnionitis and the prognosis for term infants. Obstet Gynecol 1999, 94(2):274-278.
10. Seong H.S., Lee S.E., Kang J.H., et al. The frequency of microbial invasion of the amniotic cavity and histologic chorioamnionitis in women at term with intact membranes in the presence or absence of labor. Am J Obstet Gynecol 2008, 199(4):375. e1-5.
11. Blume H.K., Li C.I., Loch C.M., et al. Intrapartum fever and chorioamnionitis as risks for encephalopathy in term newborns: a case-control study. Dev Med Child Neurol 2008, 50(1):19-24.
12. Rouse D.J., Landon M., Leveno K.J., et al. The Maternal-Fetal Medicine Units cesarean registry: chorioamnionitis at term and its duration-relationship to outcomes. Am J Obstet Gynecol 2004, 191:211.
13. Soper D.E., Mayhall C.G., Froggatt J.W. Characterization and control of intraamniotic infection in an urban teaching hospital. Am J Obstet Gynecol 1996, 175(2):304-309. [discussion: 309-10].
14. Seaward P.G., Hannah M.E., Myhr T.L., et al. International Multicentre Term Prelabor Rupture of Membranes Study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol 1997, 177(5):1024-1029.
15. Rickert V.I., Wiemann C.M., Hankins G.D., et al. Prevalence and risk factors of chorioamnionitis among adolescents. Obstet Gynecol 1998, 92(2):254-257.
16. Yancey M.K., Duff P., Clark P., et al. Peripartum infection associated with vaginal group B streptococcal colonization. Obstet Gynecol 1994, 84(5):816-819.
17. Newton E.R., Piper J., Peairs W. Bacterial vaginosis and intraamniotic infection. Am J Obstet Gynecol 1997, 176(3):672-677.
18. Abele-Horn M., Peters J., Genzel-Boroviczény O., et al. Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity. Infection 1997, 25(5):286-291.
19. Anderson B.L., Simhan H.N., Simons K.M., et al. Untreated asymptomatic group B streptococcal bacteriuria early in pregnancy and chorioamnionitis at delivery. Am J Obstet Gynecol 2007, 196(6):524. e1-5.
20. Dinsmoor M.J., Gibbs R.S. Previous intra-amniotic infection as a risk factor for subsequent peripartal uterine infections. Obstet Gynecol 1989, 74(3 Pt 1):299-301.
21. Goldenberg R.L., Andrews W.W., Hauth J.C. Choriodecidual infection and preterm birth. Nutr Rev 2002, 60(5 Pt 2):S19-S25.
22. Fahey J.O. Clinical management of intra-amniotic infection and chorioamnionitis: a review of the literature. J Midwifery Womens Health 2008, 53(3):227-235.
23. Dashe J.S., Rogers B.B., McIntire D.D., et al. Epidural analgesia and intrapartum fever: placental findings. Obstet Gynecol 1999, 93(3):341-344.
24. Apantaku O., Mulik V. Maternal intra-partum fever. J Obstet Gynaecol 2007, 27(1):12-15.
25. ACOG Committee on Practice Bulletins-Obstetrics ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 2007, 109(4):1007-1019.
26. Riggs J.W., Blanco J.D. Pathophysiology, diagnosis, and management of intraamniotic infection. Semin Perinatol 1998, 22(4):251-259.
27. Gomez R., Ghezzi F., Romero R., et al. Premature labor and intra-amniotic infection. Clinical aspects and role of the cytokines in diagnosis and pathophysiology. Clin Perinatol 1995, 22:281.
28. Harirah H., Donia S.E., Hsu C.D. Amniotic fluid matrix metalloproteinase-9 and interleukin-6 in predicting intra-amniotic infection. Obstet Gynecol 2002, 99:80.
29. Gauthier D.W., Meyer W.J. Comparison of gram stain, leukocyte esterase activity, and amniotic fluid glucose concentration in predicting amniotic fluid culture results in preterm premature rupture of membranes. Am J Obstet Gynecol 1992, 167:1092.
30. Kim K.W., Romero R., Park H.S., et al. A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes. Am J Obstet Gynecol 2007, 197(3):292. e1-5.
31. Romero R., Yoon B.H., Mazor M., et al. A comparative study of the diagnostic performance of amniotic fluid glucose, white blood cell count, interleukin-6, and gram stain in the detection of microbial invasion in patients with preterm premature rupture of membranes. Am J Obstet Gynecol 1993, 169(4):839-851.
32. Hoskins I.A., Marks F., Ordorica S.A., et al. Leukocyte esterase activity in amniotic fluid: normal values during pregnancy. Am J Perinatol 1990, 7(2):130-132.
33. Maeda K., Matsuzaki N., Fuke S., et al. Value of the maternal interleukin 6 level for determination of histologic chorioamnionitis in preterm delivery. Gynecol Obstet Invest 1997, 43(4):225-231.
34. Steinborn A., Sohn C., Scharf A., et al. Serum intercellular adhesion molecule-1 levels and histologic chorioamnionitis. Obstet Gynecol 2000, 95(5):671-676.
35. Zou L., Zhang H., Zhu J., et al. The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes. J Huazhong Univ Sci Technolog Med Sci 2004, 24(2):154-157.
36. Wu H.C., Shen C.M., Wu Y.Y., et al. Subclinical histologic chorioamnionitis and related clinical and laboratory parameters in preterm deliveries. Pediatr Neonatol 2009, 50(5):217-221.
37. van de Laar R., van der Ham D.P., Oei S.G., et al. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol 2009, 147(2):124-129.
38. Andrews W.W., Cliver S.P., Biasini F., et al. Early preterm birth: association between in utero exposure to acute inflammation and severe neurodevelopmental disability at 6 years of age. Am J Obstet Gynecol 2008, 198(4):466. e1--466.e11.
39. Dong Y., St.Clair P.J., Ramzy I., et al. A microbiologic and clinical study of placental inflammation at term. Obstet Gynecol 1987, 70:175.
40. Holzman C., Lin X., Senagore P., et al. Histologic chorioamnionitis and preterm delivery. Am J Epidemiol 2007, 166(7):786-794.
41. Pettker C.M., Buhimschi I.A., Magloire L.K., et al. Value of placental microbial evaluation in diagnosing intra-amniotic infection. Obstet Gynecol 2007, 109(3):739-749.
42. Smulian J.C., Shen-Schwarz S., Vintzileos A.M., et al. Clinical chorioamnionitis and histologic placental inflammation. Obstet Gynecol 1999, 94:1000.
43. Holcroft C.J., Askin F.B., Patra A., et al. Are histopathologic chorioamnionitis and funisitis associated with metabolic acidosis in the preterm fetus?. Am J Obstet Gynecol 2004, 191(6):2010-2015.
44. Sperling R.S., Newton E., Gibbs R.S. Intraamniotic infection in low-birth-weight infants. J Infect Dis 1988, 157(1):113-117.
45. Waites K.B., Katz B., Schelonka R.L. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev 2005, 18(4):757-789.
46. Cassell G.H., Waites K.B., Watson H.L., et al. Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns. Clin Microbiol Rev 1993, 6(1):69-87.
47. Yoon B.H., Romero R., Park J.S., et al. Microbial invasion of the amniotic cavity with Ureaplasma urealyticum is associated with a robust host response in fetal, amniotic, and maternal compartments. Am J Obstet Gynecol 1998, 179(5):1254-1260.
48. Witt A., Berger A., Gruber C.J., et al. Increased intrauterine frequency of Ureaplasma urealyticum in women with preterm labor and preterm premature rupture of the membranes and subsequent cesarean delivery. Am J Obstet Gynecol 2005, 193(5):1663-1669.
49. Donders G.G., Vereecken A., Bosmans E., et al. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 2002, 109(1):34-43.
50. Silver H.M. Listeriosis during pregnancy. Obstet Gynecol Surv 1998, 53(12):737-740.
51. Buhimschi C.S., Sfakianaki A.K., Hamar B.G., et al. A low vaginal " pool" amniotic fluid glucose measurement is a predictive but not a sensitive marker for infection in women with preterm premature rupture of membranes. Am J Obstet Gynecol 2006, 194:309.
52. Hauth J.C., Gilstrap L.C., Hankins G.D., et al. Term maternal and neonatal complications of acute chorioamnionitis. Obstet Gynecol 1985, 66:59.
53. Mark S.P., Croughan-Minihane M.S., Kilpatrick S.J. Chorioamnionitis and uterine function. Obstet Gynecol 2000, 95:909.
54. Satin A.J., Maberry M.C., Leveno K.J., et al. Chorioamnionitis: a harbinger of dystocia. Obstet Gynecol 1992, 79:913.
55. Newton E.R., Schroeder B.C., Knape K.G., et al. Epidural analgesia and uterine function. Obstet Gynecol 1995, 85:749.
56. Moretti M., Sibai B.M. Maternal and perinatal outcome of expectant management of premature rupture of membranes in the midtrimester. Am J Obstet Gynecol 1988, 159(2):390-396.
57. Gomez R., Romero R., Ghezzi F., et al. The fetal inflammatory response syndrome. Am J Obstet Gynecol 1998, 179(1):194-202.
58. Gotsch F., Romero R., Kusanovic J.P., et al. The fetal inflammatory response syndrome. Clin Obstet Gynecol 2007, 50(3):652-683.
59. Pacora P., Chaiworapongsa T., Maymon E., et al. Funisitis and chorionic vasculitis: the histological counterpart of the fetal inflammatory response syndrome. J Matern Fetal Neonatal Med 2002, 11:18-25.
60. Yoon B.H., Romero R., Kim K.S., et al. A systemic fetal inflammatory response and the development of bronchopulmonary dysplasia. Am J Obstet Gynecol 1999, 181(4):773-779.
61. Mittendorf R., Covert R., Montag A.G., et al. Special relationships between fetal inflammatory response syndrome and bronchopulmonary dysplasia in neonates. J Perinat Med 2005, 33(5):428-434.
62. Bashiri A., Burstein E., Mazor M. Cerebral palsy and fetal inflammatory response syndrome: a review. J Perinat Med 2006, 34(1):5-12.
63. Lee S.E., Romero R., Jung H., et al. The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity. Am J Obstet Gynecol 2007, 197(3):294. e1-6.
64. Aaltonen R., Vahlberg T., Lehtonen L., et al. Ureaplasma urealyticum: no independent role in the pathogenesis of bronchopulmonary dysplasia. Acta Obstet Gynecol Scand 2006, 85(11):1354-1359.
65. Aaltonen R., Heikkinen J., Vahlberg T., et al. Local inflammatory response in choriodecidua induced by Ureaplasma urealyticum. BJOG 2007, 114(11):1432-1435.
66. Goldenberg R.L., Andrews W.W., Goepfert A.R., et al. The Alabama Preterm Birth Study: umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants. Am J Obstet Gynecol 2008, 198(1):43. e1-5.
67. Jacobsson B., Aaltonen R., Rantakokko-Jalava K., et al. Quantification of Ureaplasma urealyticum DNA in the amniotic fluid from patients in PTL and pPROM and its relation to inflammatory cytokine levels. Acta Obstet Gynecol Scand 2009, 88(1):63-70.
68. Yoder P.R., Gibbs R.S., Blanco J.D., et al. A prospective, controlled study of maternal and perinatal outcome after intra-amniotic infection at term. Am J Obstet Gynecol 1983, 145:695.
69. Morales W.J., Washington S.R., Lazar A.J. The effect of chorioamnionitis on perinatal outcome in preterm gestation. J Perinatol 1987, 7:105.
70. Lau J., Magee F., Qiu Z., et al. Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only. Am J Obstet Gynecol 2005, 193:708.
71. Aziz N., Cheng Y.W., Caughey A.B. Neonatal outcomes in the setting of preterm premature rupture of membranes complicated by chorioamnionitis. J Matern Fetal Neonatal Med 2009, 22:780-784.
72. Ramsey P.S., Lieman J.M., Brumfield C.G., et al. Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol 2005, 192:1162.
73. Cornette L. Fetal and neonatal inflammatory response and adverse outcome. Semin Fetal Neonatal Med 2004, 9:459.
74. Wu Y.W., Escobar G.J., Grether J.K., et al. Chorioamnionitis and cerebral palsy in term and near-term infants. JAMA 2003, 290:2677.
75. Nelson K.B., Ellenberg J.H. Antecedents of cerebral palsy. I. Univariate analysis of risks. Am J Dis Child 1985, 139:1031.
76. Gilstrap L.C., Cox S.M. Acute chorioamnionitis. Obstet Gynecol Clin North Am 1989, 16:373.
77. Gibbs R.S., Dinsmoor M.J., Newton E.R., et al. A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection. Obstet Gynecol 1988, 72:823.
78. Sperling R.S., Ramamurthy R.S., Gibbs R.S. A comparison of intrapartum versus immediate postpartum treatment of intra-amniotic infection. Obstet Gynecol 1987, 70:861.
79. Gilstrap L.C., Leveno K.J., Cox S.M., et al. Intrapartum treatment of acute chorioamnionitis: impact on neonatal sepsis. Am J Obstet Gynecol 1988, 159:579.
80. Maberry M.C., Gilstrap L.C. Intrapartum antibiotic therapy for suspected intraamniotic infection: impact on the fetus and neonate. Clin Obstet Gynecol 1991, 34:345.
81. Hopkins L., Smaill F. Antibiotic regimens for management of intraamniotic infection. Cochrane Database Syst Rev 2002, 3. CD003254.
82. Locksmith G.J., Chin A., Vu T., et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol 2005, 105:473.
83. Edwards R.K., Duff P. Single additional dose postpartum therapy for women with chorioamniotis. Obstet Gynecol 2003, 102:957.
84. Dinsmoor M.J., Newton E.R., Gibbs R.S. A randomized, double-blind, placebo-controlled trial of oral antibiotic therapy following intravenous antibiotic therapy for postpartum endometritis. Obstet Gynecol 1991, 77:60.
85. Impey L.W., Greenwood C.E., Black R.S., et al. The relationship between intrapartum maternal fever and neonatal acidosis as risk factors for neonatal encephalopathy. Am J Obstet Gynecol 2008, 198:49.
86. Impey L., Greenwood C., MacQuillan K., et al. Fever in labour and neonatal encephalopathy: a prospective cohort study. BJOG 2001, 108(6):594-597.
87. Kenyon S.L., Taylor D.J., Tarnow-Mordi W., ORACLE Collaborative Group Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial. ORACLE Collaborative Group. Lancet 2001, 357(9261):979-988.
88. Kenyon S.L., Taylor D.J., Tarnow-Mordi W., ORACLE Collaborative Group Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group. Lancet 2001, 357(9261):989-994.
89. Kenyon S., Boulvain M., Neilson J. Antibiotics for preterm rupture of the membranes: a systematic review. Obstet Gynecol 2004, 104(5 Pt 1):1051-1057.
90. Kenyon S., Pike K., Jones D.R., et al. Childhood outcomes after prescription of antibiotics to pregnant women with preterm rupture of the membranes: 7-year follow-up of the ORACLE I trial. Lancet 2008, 372:1310-1318.
91. Kenyon S., Pike K., Jones D.R., et al. Childhood outcomes after prescription of antibiotics to pregnant women with spontaneous preterm labour: 7-year follow-up of the ORACLE II trial. Lancet 2008, 372:1319-1327.
92. Mercer B.M., Miodovnik M., Thurnau G.R., et al. Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. JAMA 1997, 278(12):989-995.
93. American College of Obstetricians and Gynecologists Practice bulletin number 47, October 2003: prophylactic antibiotics in labor and delivery. Obstet Gynecol 2003, 102(4):875-882.
94. Simhan H.N., Canavan T.P. Preterm premature rupture of membranes: diagnosis, evaluation and management strategies. BJOG 2005, 112(Suppl 1):32-37.
95. Dare M.R., Middleton P., Crowther C.A., et al. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Syst Rev 2006, 1. CD005302.
96. Ramsey P.S., Nuthalapaty F.S., Lu G., et al. Contemporary management of preterm premature rupture of membranes (PPROM): a survey of maternal-fetal medicine providers. Am J Obstet Gynecol 2004, 191(4):1497-1502.
97. Morris J.M., Roberts C.L., Crowther C.A., et al. Protocol for the immediate delivery versus expectant care of women with preterm prelabour rupture of the membranes close to term (PPROMT) Trial [ISRCTN44485060]. BMC Pregnancy Childbirth 2006, 6:9.
98. van der Ham D.P., Nijhuis J.G., Mol B.W., et al. Induction of labour versus expectant management in women with preterm prelabour rupture of membranes between 34 and 37 weeks (the PPROMEXIL-trial). BMC Pregnancy Childbirth 2007, 7:11.
99. Schrag S., Gorwitz R., Fultz-Butts K., et al. Prevention of perinatal group B streptococcal disease. Revised guidelines from the CDC. MMWR 2002, 51(No. RR-11):1-22.
100. Adair C.D., Ernest J.M., Sanchez-Ramos L., et al. Meconium-stained amniotic fluid-associated infectious morbidity: a randomized, double-blind trial of ampicillin-sulbactam prophylaxis. Obstet Gynecol 1996, 88(2):216-220.