Chorioamnionitis is a bacterial infection affecting the membranes, fluid, and placenta surrounding the fetus in the uterus. Also known as an intra-amniotic infection, it is a serious complication of pregnancy that can lead to significant illness for both the mother and the newborn baby. It occurs when bacteria, often from the mother’s lower genital tract, ascend into the uterus. This infection is a common cause of preterm birth and can result in severe complications like maternal sepsis or neonatal infection. Implementing preventative measures is crucial for a healthier pregnancy outcome.
Identifying Key Risk Factors
Certain circumstances and pre-existing conditions significantly increase the likelihood of developing an intra-amniotic infection. One of the most common and influential factors is the prolonged rupture of membranes, often called “water breaking,” for an extended period before delivery. When the protective barrier of the amniotic sac is broken, it provides a pathway for bacteria to travel up the birth canal and into the sterile environment of the uterus.
The risk is also elevated with preterm labor, as the condition is seen in a much higher percentage of preterm births compared to full-term deliveries. Another factor is the frequency of internal vaginal examinations, particularly after the membranes have ruptured, because each examination can introduce bacteria higher into the genital tract. A long labor duration, especially after the water has broken, further compounds this risk.
Pre-existing maternal infections of the lower genital tract also predispose a person to chorioamnionitis. This includes conditions such as bacterial vaginosis (BV) or untreated sexually transmitted infections (STIs). Additionally, being in a first pregnancy, known as nulliparity, is an independent risk factor for the development of this infection.
Daily Hygiene and Infection Management Practices
Preventing the migration of bacteria from the lower genital tract is a primary goal that can be actively managed through daily practices. Promptly recognizing and treating any signs of infection is a highly effective strategy for prevention. This includes seeking immediate medical attention for symptoms of common lower tract infections, such as a urinary tract infection (UTI), yeast infection, or bacterial vaginosis.
Maintaining strict personal hygiene, particularly perineal cleanliness, helps reduce the bacterial load near the vaginal opening. It is important to avoid practices that disrupt the natural balance of the vaginal microbiome. This means refraining from douching, which can flush bacteria higher into the reproductive tract and change the protective vaginal pH.
Safe sexual practices during pregnancy are also a consideration to minimize the introduction of new bacteria or pathogens. Any symptoms of unusual discharge, odor, irritation, or pelvic discomfort should be reported to a healthcare provider without delay. Early identification and antibiotic treatment of a lower tract infection prevents the bacteria from ascending and causing a more serious uterine infection.
Clinical and Procedural Prevention Strategies
Healthcare providers implement specific protocols in clinical settings to reduce the chances of an intra-amniotic infection, especially for those identified as high-risk. One protocol involves screening for and treating specific bacteria, such as Group B Streptococcus (GBS), typically performed late in the third trimester. Treating a GBS positive result with prophylactic antibiotics during labor is a standard measure to prevent transmission and reduce infection risk.
For cases where the membranes rupture prematurely (PPROM), providers often administer a course of prophylactic antibiotics to reduce the risk of chorioamnionitis and prolong the pregnancy. During labor, particularly after the water has broken, the number of internal vaginal examinations is carefully minimized. Each check carries a risk of introducing bacteria, so providers rely on external monitoring and other clinical signs whenever possible to track labor progress.
Screening and treating pre-existing infections, like bacterial vaginosis or STIs, early in the pregnancy is another targeted clinical strategy. By eradicating these organisms before they can ascend, the overall risk of an intra-amniotic infection is lowered.