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  • Also known as intra-amniotic infection[1]
  • Bacterial infection of fetal amnion and chorion membranes
  • Most commonly an ascending infection from normal vaginal flora

Risk Factors

  • Young age
  • Low socioeconomic status
  • Multiple vaginal examinations
  • Nulliparity
  • Extended duration of labor and ruptured membranes
  • Pre-existing genital tract infections


Clinical Features

Signs and Symptoms

  • Maternal fever (intra-partum temperature >100.4 °F or >37.8 °C)[2]
  • Significant maternal tachycardia (>120 beats/min)
  • Fetal tachycardia (>160-180 beats/min)
  • Purulent or foul-smelling amniotic fluid or vaginal discharge
  • Uterine tenderness
  • Maternal leukocytosis (total blood leukocyte count >15,000-18,000 cell/µL)


  • Severity of presentation is broad. Patient may appear toxic or may have silent chorioamnionitis, which still puts fetus at risk for neonatal sepsis.

Differential Diagnosis

Abdominal Pain in Pregnancy

<20 Weeks

>20 Weeks



  • Avoid digital cervical exam
  • Speculum exam should be done with sterile speculum



Given concern for neonatal sepsis, patients should be admitted for IV antibiotics, supportive care, and possible early delivery[4]


  • Placental abruption
  • Premature birth
  • Neonatal sepsis
  • Neonatal death
  • Cerebral palsy
  • Maternal sepsis
  • Need for cesarean delivery
  • Postpartum hemorrhage

See Also

External Links


  1. Abbrescia K, Sheridan B. Complications of second and third trimester pregnancies. Emerg Med Clin N Am 21 (2003): 695-710.
  2. Apantaku O, Mulik V. Maternal intra-partum fever. J Obstet Gynaecol. 2007 Jan; 27(1):12-5.
  3. Snyder M. et al. Clinical inquiries. What treatment approach to intrapartum maternal fever has the best fetal outcomes?. J Fam Pract. May 2007;56(5):401-2
  4. Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5