MANAGEMENT OF CHORIOAMNIONITIS

  • 1 January 1984
    • journal article
    • research article
    • Vol. 158  (2) , 161-166
Abstract
Chorioamnionitis presents as a serious threat to both mother and fetus. Diagnostic criteria and method of management were evaluated by means of a retrospective analysis. Ninety-nine percent of mothers had 2 of 3 major risk factors, i.e., rupture of membranes [ROM], leukocytosis of greater than 15,000, and temperature greater than 100.4.degree. F. All 3 risk factors were present in 82.7%. Management included culturing the endocervix when premature rupture of the membranes was present, administering parenteral antibiotics once the diagnosis of chorioamnionitis was made and performing cesarean sections for obstetric indications only. This management protocol resulted in a perinatal survival rate of 94.9% in infants weighing more than 1000 g compared with 98.3% in the general population and no perinatal deaths in infants weighing more than 1500 g. There were no maternal deaths. Endocervical cultures should be obtained for all patients with premature rupture of membranes; mothers with ROM and normal temperature and white blood cell count should be managed without antibiotics; mothers with a diagnosis of chorioamnionitis should have induction of labor and cesarean section for obstetric indications only.