Intra-amniotic infection increases the risk of problems in the woman and in the fetus.
Women usually have a fever and often have pelvic pain and a vaginal discharge.
Usually, doctors can diagnose the infection by doing a physical examination, but sometimes amniotic fluid must be analyzed.
Women are given antibiotics and drugs to lower body temperature, and delivery is scheduled as soon as possible.
Pregnancy complications, such as intra-amniotic infection, are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur at different times during the pregnancy. However, most pregnancy complications can be effectively treated.
Intra-amniotic infection typically develops because bacteria from the vagina enter the uterus and infect the tissues around the fetus. Normally, mucus in the cervix, the membranes around the fetus, and the placenta prevent bacteria from causing infection. However, certain conditions can make it easier for bacteria to breach these defenses. For example, the membranes around the fetus may rupture too soon (called premature rupture of the membranes Prelabor Rupture of the Membranes (PROM) Prelabor rupture of the membranes is the leaking of amniotic fluid from around the fetus at any time before labor starts. After the membranes rupture, labor often soon follows. If labor does... read more ). Rarely, infection occurs when internal fetal monitoring Fetal monitoring Labor is a series of rhythmic, progressive contractions of the uterus that gradually move the fetus through the lower part of the uterus (cervix) and birth canal (vagina) to the outside world... read more is done. For this procedure, doctors monitor the fetus by inserting an electrode (a small round sensor attached to a wire) through the woman’s vagina and attached to the fetus’s scalp.
The more time that passes between when the membranes rupture and delivery occurs, the more likely intra-amniotic infection is to develop, particularly if doctors or midwives do many pelvic examinations. Such examinations may introduce bacteria into the vagina and uterus.
Having bacteria that can cause infections in the genital tract also makes intra-amniotic infections more likely. Women may not know that these bacteria are present, particularly if they have not had routine prenatal care, when tests for these bacteria would have been done.
Intra-amniotic infection is also more likely if
The amniotic fluid contains meconium (the dark green stool that is produced by the fetus before birth and that is usually only expelled after birth).
Labor lasts a long time.
Intra-amniotic infection can increase the risk of the following problems in the fetus:
Preterm delivery or preterm premature rupture of the membranes (rupture of the membranes before 37 weeks of pregnancy)
Too little oxygen in the blood around the time of delivery
Infections, such as a bodywide infection ( sepsis Sepsis and Septic Shock Sepsis is a serious bodywide response to bacteremia or another infection plus malfunction or failure of an essential system in the body. Septic shock is life-threatening low blood pressure ... read more ), pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more , or meningitis Meningitis in Children Bacterial meningitis is a serious infection of the layers of tissue covering the brain and spinal cord ( meninges). Bacterial meningitis in older infants and children usually results from bacteria... read more
Intra-amniotic infection can cause as well as result from preterm delivery or preterm premature rupture of the membranes.
Intra-amniotic infection can increase the risk of the following problems in the woman:
A collection of pus (abscess) around the uterus
Infection of incisions made during delivery
Rarely, if an intra-amniotic infection is not treated, women may develop septic shock Sepsis and Septic Shock Sepsis is a serious bodywide response to bacteremia or another infection plus malfunction or failure of an essential system in the body. Septic shock is life-threatening low blood pressure ... read more (life-threatening low blood pressure caused by a serious bodywide response to infection), disseminated intravascular coagulation Disseminated Intravascular Coagulation (DIC) Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets... read more (a blood clotting disorder that causes blood clots and bleeding), and acute respiratory distress syndrome Acute Respiratory Distress Syndrome (ARDS) Acute respiratory distress syndrome is a type of respiratory (lung) failure resulting from many different disorders that cause fluid to accumulate in the lungs and oxygen levels in the blood... read more .
Symptoms of Intra-Amniotic Infection
Intra-amniotic infection usually causes fever and often causes abdominal pain and a discharge that can be foul-smelling. The heart rate of the fetus and the woman may be rapid. However, some women do not have typical symptoms.
Diagnosis of Intra-Amniotic Infection
A doctor's evaluation
A complete blood count
Doctors do a physical examination and a complete blood count (which includes a white blood cell count).
An intra-amniotic infection is suspected when women have a fever and there is another typical symptom, such as a fast heart rate in the fetus or a foul-smelling discharge or an abnormally high white blood cell count in the woman. If the diagnosis is still unclear, doctors can remove a sample of the amniotic fluid and analyze it ( amniocentesis Amniocentesis Prenatal diagnostic testing involves testing the fetus before birth (prenatally) to determine whether the fetus has certain abnormalities, including certain hereditary or spontaneous genetic... read more ).
If preterm labor or premature rupture of membranes occurs, doctors consider the possibility of infection even if women do not have typical symptoms.
Prevention of Intra-Amniotic Infection
If women have preterm premature rupture of the membranes, doctors do pelvic examinations only if necessary.
Doctors usually also give these women antibiotics intravenously or by mouth to help the pregnancy last longer and reduce the risk of problems in the fetus.
Treatment of Intra-Amniotic Infection
Drugs to lower body temperature
Women with an intra-amniotic infection are given antibiotics intravenously. They are also given drugs such as acetaminophen to lower body temperature.
Delivery should not be delayed once the diagnosis is made.
If labor has not started, labor may be artificially started ( induced Induction of Labor Induction of labor is the artificial starting of labor. Usually, labor is induced by giving the woman oxytocin, a drug that makes the uterus contract more frequently and more forcefully. The... read more ).
Immediate cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more is not usually necessary if the mother and fetus are stable and if antibiotics are given while labor is being induced.