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Introduction

Intraamniotic infection (IAI), also known as clinical chorioamnionitis, is an infection of the uterine decidua, placenta, amniotic fluid, membranes, and umbilical cord.  IAI is associated with increased neonatal morbidity and mortality, particularly at preterm gestations.  Maternal complications can include sepsis, postpartum hemorrhage, and postpartum endometritis.

Pathogenesis

IAI typically occurs due to bacteria ascending from the lower genital tract into the normally sterile uterus, through the cervix, and into the amniotic cavity.  This ascent of bacteria can happen during pregnancy, during labor, or after the rupture of membranes.  The risk is particularly high with prolonged rupture of membranes (eg, prelabor rupture of membranes) and prolonged/protracted labor, which allows more time for bacterial migration and proliferation.

IAI is usually a polymicrobial infection involving a mixture of aerobes and anaerobes consisting of common colonizers of the lower genital tract (eg, group B

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Tables

Table 1