Chorioamnionitis
internal monitoring requirements
- ROM - dilatation - close access to fetal head
s/s of chorioamnionitis
- maternal tachycardia and fever - fetal tachycardia (signs of fetal infection) - malodorous amniotic fluid - uterine tenderness
maternal risks from chorioamnionitis
- septicemia - pelvic peritonitis - abscess formation - septic thrombophlebitis - endometritis
contributing factors to the development of chorioamnionitis
- sexual intercourse in late pregnancy - poor maternal nutrition - repeated vaginal exam - presence of vaginitis/ cervicitis - cerclage - low SES
neonatal effects from chorioamnionitis
- skin color changes: jaundice - activity changes: decreased activity; does not feed well - impaired thermoregulation: HYPOTHERMIC - abdominal distention
incidence of chorioamnionitis
0.5 to 1.0% possibly as high as 25%
fetal tachycardia
160 bpm
pPROM
Preterm PROM before 37 weeks
repeated vaginal exam in the role of developing chorioamnionitis
after ROM increases risk for chorio
uterine tenderness is due to
amniotic fluid/ membranes develop an infection -- spreads to endometrial lining -- spreads to myometrium = inflammation in myometrium causes uterine tenderness upon palpation
cerclage in the role of developing chorioamnionitis
can be a media for organisms to grow into the uterine environment
poor maternal nutrition in the role of developing chorioamnionitis
decreases resistance to infections
if chorioaminonitis is not treated successfully it can lead to
endometritis
s/s of endometritis
fever, odor to lochia, heavy bleeding
malodorous amniotic fluid
foul smelling odor
septicemia
full blow systemic infection
what increases risk for developing a chorioamnionitis?
if mom already has an infection in the reproductive tract (ie cervical infection, vaginal infection); these organisms can move into the reproductive tract once membranes have ruptured
fever in mom results in
increased basal metabolic rate = tachycardia
chorioamnionitis
infection of the amnion, chorion (membranes), and amniotic fluid - also referred to as amnionitis, intrapartal infection, intra-amniotic infection or "chorio"
internal fetal monitoring in the role of developing chorioamnionitis
is a direct path from the extrauterine environment to the intrauterine environment
Unexplained Jaundice
jaundice not due to blood incompatibility
intrauterine pressure catheter (IUPC)
measures the strength of uterine contractions; internal catheter that gives us exact data about intrauterine pressure changes
group B beta strep effect on mom
part of normal flora
chorioamnonitis is commonly seen in
patients with prolonged rupture of membranes
PROM
premature rupture of membranes
group B beta strep effect on newborn
respiratory infection and neonatal sepsis
prolonged rupture of membranes
rupture of membranes for more than 24 hours prior to delivery; if there is an infection present in the reproductive tract, rupture of membranes for longer than 18 hours is considered prolonged rupture of membranes