Intraamnotic infection - Corioamnionitis

The intra-uterine infection chorioamnionitis or triple I is an infection of the placental membranes and the amniotic contents (fluid, cord and fetus).

It is present in 4% of at term deliveries and in 8-50% of preterm deliveries.

The cause tends to be an infection originated in the inferior genitourinary tract (cervical and vaginal area), that migrates upward to the amniotic cavity. It is associated with preterm delivery labor, premature membrane rupture and prolonged delivery labor.

We suspect that this entity exists when maternal fever appears (temperature above 38ºC / 100.4ºF) and one of the following symptoms:

• Purulent cervical flux
• Fetal tachycardia (160 bpm)
• High level of leukocytes in blood (above 15,000)

​The diagnosis is confirmed through an amniocentesis, and/or an endocervical, vaginal or rectal culture.

The treatment is based on antibiotics, antipyretics and the ending of the pregnancy. Below 34 gestational weeks, corticosteroids will be administered to mature the fetus lungs and below 32 weeks, magnesium sulfate to protect the fetus's nervous system.

It increases the risk of complications for the fetus and the mother. At the fetal level, there is an increased risk of retinopathy, bronchopulmonary dysplasia, respiratory distress syndrome, neonatal sepsis, intracranial hemorrhage and neurodevelopmental impairment. At the maternal level, there is an increased risk of postpartum hemorrhage, uterine rupture, hysterectomy, endometritis, sepsis and maternal mortality.