Let's learn about chorioamnionitis, a possible infection of the amniotic fluid during pregnancy.

If you are pregnant, you must be thinking a lot about the safety of you and your baby, right? Sometimes we don't even hear about it, but there are some conditions that can occur during pregnancy. One such condition that requires a little attention, but nothing to worry about, is Chorioamnionitis. Shall we talk about this simply?

What is chorioamnionitis? How common is it?

Simply put, chorioamnionitis is a serious infection that you can get during pregnancy . It gets its name from the two membranes that surround your baby in the womb. The outer membrane is called the chorion, and the inner membrane is called the amnion. These are the membranes that surround your baby, the amniotic fluid. Think of your baby as being in a protective bag of water. This infection occurs when bacteria get into these membranes, or tissues, that surround your baby. That is:

• Chorion (the outermost membrane surrounding the baby)
• Amnion (the inner membrane surrounding the baby)
• Placenta (the part that provides food and oxygen to the baby)
• Amniotic fluid (the fluid in which the baby floats)

This condition can occur if bacteria get into any of these places. Usually, antibiotics are given as treatment. But sometimes your doctor may have to deliver your baby early. If this is not treated properly, it can be life-threatening for both you and your baby. So it's important to be aware of this. Considering how common this condition is, in countries like the United States, it occurs in between 1% and 5% of births. It is one of the causes of premature labor and premature delivery. This means that the baby is more likely to be born before the full term.

What are the symptoms of this?

The symptoms of chorioamnionitis can vary from person to person. Some people may not experience any major symptoms. However, there are a few common symptoms:

• Having a fever ( a body temperature of more than 38 degrees Celsius, or 100.4 degrees Fahrenheit).
• An increase in your or your baby's heart rate (more than 100 beats per minute for you, more than 160 for the baby).
• Feeling severe pain or tenderness when touching the uterus or pressing on the abdomen.
• A foul odor or unusual color of vaginal discharge(Like green, yellow).
• Sweating (especially with fever).
• Sometimes you may feel a tremor .

If you have one or more of these symptoms, it's best to see a doctor as soon as possible.

How does chorioamnionitis develop?

The main cause of this is a bacterial infection . These bacteria normally live in the vagina, but if they move up to the uterus, they can cause problems. This infection can start in your vagina, anus, or rectum and spread to your uterus. Or, if the amniotic sac around your baby bursts (we call it a 'broken bag of water'), this infection can start right inside your uterus. Because when the bag of water breaks, bacteria can get in. These bacteria can infect your placenta and your baby. Another thing is that frequent vaginal examinations (especially manual examinations) after your water breaks, or after a test such as amniocentesis (a test to collect a sample of amniotic fluid), can also spread this infection. The two main types of bacteria that often cause this are E. coli (a type of bacteria that is normally found in the intestines) and Group B strep. Although this bacteria, called Group B strep, is harmless in the vagina of most pregnant women, it can sometimes infect the baby during childbirth.

Can this affect the baby?

Yes, absolutely. Chorioamnionitis is a condition that can have a significant impact not only on the mother, but also on the baby in the womb. Some of the complications include:

• Serious infections (for example, an infection that spreads to the bloodstream - sepsis ).
• Brain damage or brain development effects.
• Lung problems (e.g. pneumonia ).
• Increased chance of premature birth .
• Although rare, death can even occur.

That is why it is so important to recognize and treat this condition quickly.

How do you diagnose this?

Your prenatal care provider will diagnose this condition. He or she will do a physical exam, ask about your symptoms (such as fever and abdominal pain), and take a thorough medical history. In addition, you may also:

• Check for infection or white blood cell countBlood and urine tests may be ordered (white blood cell counts are usually elevated during an infection).
• A vaginal culture can be taken and sent to a laboratory to check for bacteria.
• Sometimes, a sample of your amniotic fluid may be taken to check for bacteria. This is done through a procedure called amniocentesis.
• An ultrasound can be done to check the baby's health and heartbeat.

Based on the information obtained from these tests, the doctor decides whether this is chorioamnionitis or not.

How is this treated?

If your doctor diagnoses chorioamnionitis, the main treatment is antibiotics . These are given to kill the bacteria that are causing the infection. These antibiotics are usually given through a needle inserted into a vein (an IV). The drugs then start working quickly in your body. In some cases, especially if the infection is severe or if there is a risk to the baby's health, doctors may recommend early delivery . This can help prevent additional problems for you and your baby. After your baby is born, if your newborn baby also has an infection, they will also be given antibiotics.

Don't worry: the doctors are doing what's best for you and your baby. It's important to listen to what they say and act accordingly.

What complications can this cause?

If you have severe chorioamnionitis, or if it is left untreated, the mother may develop complications such as:

• Spread of infection to your pelvic region and abdomen .
• Endometritis, an inflammation of the lining of the uterus, can occur after childbirth.
• Blood clots in your pelvis or lungs .
• Sepsis is a blood infection that can be life-threatening .

Important: Sepsis is a serious condition that requires emergency medical treatment. It is a severe reaction of the entire body to infection.

Your newborn baby can also develop complications from this bacterial infection. For example:

• Sepsis (a serious blood infection).
• Meningitis (inflammation of the membranes surrounding the brain and spinal cord).
• Pneumonia (a lung infection).
• Breathing difficulties.
• Long-term effects on brain development (e.g. Cerebral Palsy).

This is why it is essential to be aware of this condition and seek prompt treatment.

What factors increase this risk?

Certain factors may increase your risk of developing chorioamnionitis. These include:

• Premature labor (before 37 weeks).
• The water breaks more than 18-24 hours before the baby is born (this is called a prolonged rupture of membranes).
• Labor pain lasts a long time .
• You have an untreated vaginal infection (e.g., bacterial vaginosis) or a sexually transmitted infection (STI) .
• You have a Group B strep infection (especially if it is not treated).
• Frequent vaginal examinations (manual) after the water breaks.
• Using internal fetal or uterine monitoring devices .
• First pregnancy.
• Smoking.

If you have these risk factors, talk to your doctor about them and learn about things to be especially careful about.

How can this be prevented?

While there are some things we can't control (e.g., premature rupture of the membranes), there are a few things you can do to reduce your risk of chorioamnionitis:

• If your water breaks early (before 37 weeks), take antibiotics as prescribed by your doctor . This can reduce the risk of infection.
• Limit the number of vaginal examinations after your water breaks. These examinations should be performed only when absolutely necessary and with care.
• Get tested for Group B strep during the third trimester (between weeks 35 and 37) of pregnancy. If you are diagnosed with this bacteria, you will be given antibiotics when labor begins or your water breaks to prevent infection in your baby.
• If you have symptoms of a vaginal infection (such as unusual discharge, itching), seek treatment immediately.
• Avoiding smoking.

If you are concerned or have any concerns about chorioamnionitis, talk to your prenatal care provider. He or she can assess your situation and tell you about your risk.

When should I see the doctor?

While you're pregnant, there are some symptoms you should be especially aware of. If your membranes break (your water breaks), call your obstetrician or hospital right away. Also, be sure to see your doctor if you have any of these symptoms:

• If you have a fever (especially without any other cold symptoms).
• New pain or stiffness in the abdomen or pelvic areaIf you feel like it.
• If your vaginal discharge smells bad or has changed color.
• If your heart rate feels like it's just speeding up .

Acting quickly at times like this can protect you and your baby.

Can a baby survive in the womb without amniotic fluid?

No, a baby cannot survive in the womb for long without amniotic fluid. Amniotic fluid is a very important substance that protects the baby, helps the baby's lungs and kidneys develop, and regulates temperature. Without it, the baby can easily become infected. It can also lead to other life-threatening complications, such as umbilical cord compression. Your doctor will decide the best time to deliver your baby based on how far along you are in your pregnancy.

How long can the baby survive after my water breaks?

This varies from person to person. It also depends on many things, such as the stage of pregnancy (how mature the baby is) and whether there are any signs of infection. However, in general, most doctors want to deliver your baby within 24 hours of your water breaking. Especially if your water breaks at a very advanced stage (like after 34 weeks), the risk of infection is higher, so delivering your baby early is the safest option. However, if your baby is very premature (like between 24-34 weeks), sometimes doctors may try to keep your baby in the womb for a few more days by giving them antibiotics, along with medications like steroids to help the baby's lungs develop.

Final Take-Home Message

Chorioamnionitis is a serious condition that can occur during pregnancy. However, while you can't control it, you can do things like recognize the symptoms and tell your prenatal care provider about all your symptoms. Treatment usually involves antibiotics. However, sometimes you may have to deliver your baby early. If you are diagnosed with this condition, be sure to talk to your doctor about it and ask any questions you may have. The most important thing is to stay calm and follow your doctor's instructions. There are doctors who are concerned about your health and that of your baby and will take the necessary steps. So don't be afraid to talk to them about it.