Inflammation of Fetal Membranes in Pregnancy - Learn More About Intra-amniotic Infection
No matter how much you are taking care of yourself, you can still catch infection during pregnancy. It seems to be so unfair. Just at the time you are relaxing and enjoying the new life within you, you get to know you have infection.
Infection in pregnancy can be somewhat alarming as you are exposed to vulnerabilities due to weak immune system. Moreover, the body does not produce enough antibodies to fight infections. Some types of infections are mild and do not cause any harm but some other are so fatal that you will need emergency medical assistance to get rid of it.
Intra-amniotic infection is one such condition that occurs mostly during the final month of pregnancy or during labor.
Intra-amniotic infection or Chorioamnionitis refers to a bacterial infection that occurs in the last month of pregnancy or during labor process. The name is derived from ‘chorio’, the outer membrane that surrounds the fetus in the uterus and ‘amnion’, the fluid-filled sac in which the fetus floats. The infection causes inflammation to the fetal membranes.
Intra-amniotic infection or chorioamnionitis if not timely treated, can result in serious complications such as preterm delivery or severe infection in mother and the baby.
How common is intra-amniotic infection?
The condition is common in most preterm births and occurs in about 2-4 percent of all full-term deliveries.
What causes intra-amniotic infection?
Intra-amniotic infection occurs when the bacteria ascend from vagina and breaks the normal defenses of the uterus. The most common bacterias include E. Coli, Group B Strep and Anaerobic. The condition can also occur when the membranes rupture during the long delivery process. This is also known as water breaking down.
Symptoms of intra-amniotic infection
Intra-amniotic infection does not always cause symptoms. But if the infection occurs during the delivery, one can experience:
- Pain or tenderness in uterus
- Increase in heart rate of fetus and the mother
- Foul smelling, discolored vaginal discharge
Risk factors of intra-amniotic infection
There are certain risk factors that can increase the chances of chorioamnionitis. These include:
- First pregnancy
- Long delivery or labor
- Young maternal age
- Rupturing of the membranes for a long period (water breaking down)
- Pre-existing genital infection
Complications of intra-amniotic infection
Intra-amniotic infection or chorioamnionitis typically requires emergency medical assistance. The complications in mothers include:
- Infection in the lining of the uterus (endometriosis)
- Infection in the bloodstream (bacteremia)
- Infection in the pelvic region and abdomen
- Blood clots in pelvis and lungs
- Heavy blood loss
- Need for cesarean delivery
- Sepsis (blood infection)
- Respiratory problems
About 8 percent of women who undergo cesarean delivery would develop some kind of wound infection while almost 1 percent can result in pelvic abscess (collection of pus in the pelvis). Death due to intra-amniotic infection is extremely rare.
Complications in infants
- Chorioamnionitis can result in meningitis, which is infection of the brain and spinal cord, however, the occurrence is less than 1 percent in infant who are delivered timely.
- The infected infant might also develop lung infection (pneumonia) or bacteremia. This happens in about 5-10 percent of cases.
- In rare cases, the infection can be dangerous to the preterm infants.
How intra-amniotic infection is diagnosed?
Intra-amniotic infection is most commonly diagnosed by physical examination and by spotting the signs and symptoms mentioned above. The doctor might also find necessary to test amniotic fluid (amniocentesis) and search for signs of bacteria. Pregnant women may have the infection if the glucose and white blood cells concentration is high.
Sometimes the condition is suspected during the labor process. In this case, the doctor may diagnose and choose the treatment depending on the clinical symptoms.
How to cure intra-amniotic infection?
Once the doctor confirms the presence of intra-amniotic infection, you would be treated immediately to stop any further complications. The earlier the treatment is given, the sooner the fever will go down, reducing the recovery time as well as lowering the baby’s risk of catching the infection.
Anti-biotics are the most common treatment methods for intra-amniotic infection. The antibiotics are generally given intravenously and continued till the baby is delivered, usually a couple of days. Some of the common antibiotics that are given include penicillin, gentamycin, metronidazole, etc.
Prevention methods of intra-amniotic infection
The team of doctors will do their level best to prevent the infection at first place. They may opt for methods such as:
- Checking you for any vaginal inflammation (vaginosis) in the second trimester
- Checking for Group B Strep infection once you are in third trimester or 35 weeks of pregnancy
- Minimizing the number of vaginal check-ups during delivery process
- Reducing the frequency of internal monitoring
Besides, the long-term outlook for pregnant women with intra-amniotic infection is positive. A woman can become pregnant and deliver normally in future pregnancies.
The infants delivered to an infected woman too would not find any complications except a few. However, infant born preterm can experience long-term complications including impaired brain functioning and lung disease.