Diagnosis and management of clinical chorioamnionitis

Abstract

Chorioamnionitis is a common complication of pregnancy associated with significant maternal, perinatal, and long-term adverse outcomes. Adverse maternal outcomes include postpartum infections and sepsis whereas adverse infant outcomes include stillbirth, premature birth, neonatal sepsis, chronic lung disease, and brain injury leading to cerebral palsy and other neurodevelopmental disabilities. Research in the past 2 decades has expanded understanding of the mechanistic links between intra-amniotic infection and preterm delivery as well as morbidities of preterm and term infants. Recent and ongoing clinical research into better methods for diagnosing, treating, and preventing chorioamnionitis is likely to have a substantial impact on short and long-term outcomes in the neonate.

Figure 1

Routes of chorioamnionitis/funisitis

Figure 2

Pathogenesis of Chorioamnionitis: Maternal and Fetal Response and Complications IL=Interleukin, TNF=Tumor Necrosis Factor, MMP=Matrix metalloproteinase, FIRS=Fetal Inflammatory Response Syndrome, PTB Preterm birth