A pragmatic approach to recognize intrapartum chorioamnionitis

Abstract

Chorioamnionitis is a significant contributor to non-hypoxic fetal compromise, increasing the risk of neonatal encephalopathy and cerebral palsy. This paper highlights the limitations of traditional diagnostic methods for chorioamnionitis, which rely on histopathology, microbiology, and clinical signs, and emphasizes the importance of recognizing the fetal inflammatory response using intrapartum cardiotocography (CTG). By understanding the physiological pathways of inflammation, clinicians can identify characteristic CTG patterns. This pragmatic approach allows for earlier detection and intervention, potentially improving perinatal outcomes. The paper calls for a re-evaluation of clinical management practices and advocates for a multifaceted approach that incorporates CTG findings into the diagnosis of chorioamnionitis to prevent adverse neonatal outcomes.

Keywords: Cardiotocography; Chorioamnionitis; Fetal heart rate; Fetal inflammatory response; Funisitis; Intraamniotic infection; Intraamniotic inflammation.