Prevention
If the amniotic sac breaks early into pregnancy, the potential of introducing bacteria in the amniotic fluid can increase. Administering antibiotics maternally can potentially prevent chorioamnionitis and allow for a longer pregnancy. In addition, it has been shown that it is not necessary to deliver the fetus quickly after chorioamnionitis is diagnosed, so a C-section is not necessary unless maternal health concern is present. However, research has found that beginning labor early at approximately 34 weeks can lessen the likelihood of fetal death, and reduce the potential for excessive infection within the mother.In addition, providers should interview people suspected to have chorioamnionitis about whether they are experiencing signs and symptoms at scheduled obstetrics visits during pregnancy, including whether the individual has experienced excretion vaginally, febrile, or abdominal pain. Treatment
The American College of Obstetricians and Gynecologists Committee Opinion proposes the use of antibiotic treatment in intrapartum mothers with suspected or confirmed chorioamnionitis and maternal fever without an identifiable cause.Intrapartum antibiotic treatment consists of:
Standard
Ampicillin + gentamicin
Alternative
Ampicillin/sulbactam
Ticarcillin/clavulanate
Cefoxitine
Cefotetan
Piperacillin/tazobactam
Ertapenem
Cesarean delivery
Ampicillin and gentamicin plus either clindamycin or metronidazole
Penicillin-allergy
Vancomycin + gentamicin
Gentamicin + clindamycinHowever, there is not enough evidence to support the most efficient antimicrobial regimen. Starting the treatment during the intrapartum period is more effective than starting it postpartum; it shortens the hospital stay for the mother and the neonate. There is currently not enough evidence to dictate how long antibiotic therapy should last. Completion of treatment/cure is only considered after delivery. Supportive measures
Acetaminophen is often used for treating fevers and may be beneficial for fetal tachycardia.
There can be increased likelihood for neonatal encephalopathy when mothers have intrapartum fever. Outcomes
Chorioamnionitis has possible associations with numerous neonatal conditions. Intrapartum (during labor) chorioamnionitis may be associated with neonatal pneumonia, meningitis, sepsis, and death. Long-term infant complications like bronchopulmonary dysplasia, cerebral palsy, and Wilson-Mikity syndrome have been associated to the bacterial infection. Furthermore, histological chorioamnionitis may increase the likelihood of newborn necrotizing enterocolitis, where one or more sections of the bowel die. This occurs when the fetal gut barrier becomes compromised and is more susceptible to conditions like infection and sepsis. In addition, chorioamnionitis can act as a risk factor for premature birth and periventricular leukomalacia. Complications
For mother and fetus, chorioamnionitis may lead to short-term and long-term issues when microbes move to different areas or trigger inflammatory responses due to infection. Maternal complications
Higher risk for C-section
Postpartum hemorrhage
Endometritis
Bacteremia (often due to Group B streptococcus and Escherichia coli)
Pelvic abscessMothers with chorioamnionitis who undergo a C-section may be more likely to develop pelvic abscesses, septic pelvic thrombophlebitis, and infections at the surgical site. Fetal complications
Fetal death
Neonatal sepsis

Neonatal complications
Perinatal death
Asphyxia
Early onset neonatal sepsis
Septic shock
Neonatal pneumonia
Infant respiratory distressIn the long-term, infants may be more likely to experience cerebral palsy or neurodevelopmental disabilities. Disability development is related to the activation of the fetal inflammatory response syndrome (FIRS) when the fetus is exposed to infected amniotic fluid or other foreign entities. This systemic response results in neutrophil and cytokine release that can impair the fetal brain and other vital organs.