GuidelinesOther guideline
Chorioamnionitis
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
This is usually associated with prelabour rupture of membranes and preterm labour, or with antepartum haemorrhage, but may occur in the absence of any specific symptoms or signs. Both the woman and her baby are at significant risk of severe infection. It is often difficult to make a diagnosis
Clinical signs of chorio-amnionitis include:
- Pyrexia ≥37.5 degrees
- Maternal heart rate ≥100/minute
- Uterine tenderness &/or irritability
- Fetal heart rate ≥160/minute
- Offensive liquor or meconium stained liquor
Management
- If there is uncertainty about the diagnosis, exclude other causes of the presenting symptoms & signs, & admit to the antenatal ward for observation & fetal monitoring.
- Give ampicillin 2 g IV 6 hourly, with metronidazole 400 mg orally 8 hourly
- At gestation <34 weeks, give betamethasone 12 mg IM 12 hourly for 2 doses
- Induce labour if the cervix is favourable, otherwise perform caesarean section
- During labour, monitor the fetus with CTG
- Continue ampicillin and metronidazole for 5 days after delivery