Amniotic infection syndrome is a serious complication during pregnancy or the birth process. It is a serious bacterial infection of the placenta, egg cavity, membranes, and possibly fetus that must be treated immediately to save the lives of both mother and baby.
What is amniotic infection syndrome?
Amniotic infection syndrome is a serious bacterial infection of the placenta, egg cavity, membranes, and possibly fetus that must be treated immediately to save the lives of the mother and baby. Amniotic infection syndrome usually occurs in the last stage of pregnancy or during the birth process. It is often caused by bacteria invading from the outside through the vagina, which have free access to the placenta, the membranes of the egg and the child. Because the membranes of the egg are also affected, the term chorioamnionitis is also used as a synonym. Amniotic infection syndrome is a medical emergency that can be dangerous for both the mother and the child. This condition is not caused by a single pathogen. Rather, different types of bacteria can lead to the same symptoms. These pathogens include beta-hemolytic streptococci, intestinal bacteria such as Escherichia coli, staphylococci, listeria, hospital germs such as Pseudomonas aeruginosa, Klebsiella, fungus-like bacteria such as mycoplasma, gonococci or chlamydia. Prior to infection, the germs reside in the rectal or vaginal area. After premature rupture of the amniotic sac and opening of the cervix, the pathogens can freely ascend into the placenta and infect the membranes, placenta and even the baby. Even if the amniotic sac is intact, infection of the placenta, the membranes, and the baby is possible through the bloodstream.
Causes
The cause of amniotic infection syndrome is usually a mixed bacterial infection with several different pathogens. As mentioned earlier, several different types of pathogens may be involved. The prerequisite for an infection is either a free access of the germs from the outside via the vagina ascending through the cervix or via a hematogenous pathway from an infection source within the organism to the placenta. In the former case, the cause is a prematurely ruptured amniotic sac. Through the amniotic sac, the fetus floating in the amniotic fluid is protected from external influences. At the same time, it is nourished and supplied with oxygen through the umbilical cord. If too much time elapses between the rupture of the amniotic sac and birth, the conditions for infection of the placenta, the membranes of the egg or even the unborn child with various germs via the vagina become increasingly favorable. Premature rupture of the membranes also leads to the loss of amniotic fluid and negatively affects the growth of the fetus, making it susceptible to germs in addition to disrupting its development. In the case of blood-borne amniotic infection syndrome, the amniotic sac has not yet broken. In this case, however, there is a secondary risk of premature rupture of the bladder as a result of amniotic infection syndrome.
Symptoms, complaints, and signs
Amniotic infection syndrome is characterized by inflammation of the membranes of the ovaries, cervix, and uterus. Inflammation of the membranes can induce preterm labor and lead to premature birth. The newborn baby is seriously ill and may die from a condition called sepsis (blood poisoning). Sepsis is a very serious medical emergency because of the masses of bacteria that enter the bloodstream. If the child survives the sepsis, physical and mental impairments may remain as a result of the premature birth and the effects of amniotic infection syndrome. The pathogens can also cause meningitis and severe respiratory illness in the child. In the mother, the inflammation of the endometrium can also lead to sepsis, which is also a fatal danger for the pregnant woman. Even without sepsis, both the child and the mother experience severe symptoms. The unborn child is found to have an increased heart rate (tachycardia). The mother suffers from fever, pain of the uterus on palpation, preterm labor, and leukocytosis (increased formation of white blood cells). There are also foul-smelling discharges of amniotic fluid.
Diagnosis and course
The diagnosis of amniotic infection syndrome is made on the basis of the presenting symptoms and blood tests.In the case of a prematurely ruptured amniotic sac, the inflammation values in the blood must be constantly determined, the heart rate permanently monitored and the pregnant woman’s body temperature measured. If the values rise, this is considered a sign of an incipient amniotic infection syndrome. Other indications are foul-smelling amniotic fluid and pain when palpating the uterus. Even if the water has not broken yet, when these symptoms appear, everything points to amniotic infection syndrome.
Complications
Amniotic infection syndrome can affect women during pregnancy. This is an infection caused by germs in the egg membrane that surrounds the amniotic fluid of the fetus. The pathogens can cause numerous complications and, in extreme cases, abortion or sepsis. They consist of a mixed infection of streptococci, listeria, chlamydia and enterococci and find their way through the cervix and vagina into the uterus. If a pregnant woman becomes ill with amniotic infection syndrome, medical countermeasures must be initiated immediately. Typical signs include fever, sudden onset of labor, tachycardia, and increased uterine pressure. Treatment depends on the stage of pregnancy and whether premature rupture of the membranes has already occurred. Most commonly, high-dose antibiotic therapy is injected through the vein. If the 36th week of pregnancy has passed and the fetus is fully developed, the birth can be induced artificially. If the mother is too weakened by the amniotic infection syndrome, a cesarean section is advised. However, if complications from the pathogens or a rupture of the membranes occur between the 28th and 36th week of pregnancy, there is a danger to the life of the unborn child. During this time, the lungs are not yet fully mature. Only in particularly severe cases is an attempt made to retrieve the child, who must then be intensively cared for in the premature infant ward.
When should you go to the doctor?
Amnioinfectious syndrome must be treated immediately in all cases. As a rule, without treatment, the death of the child and the mother occurs directly, which is why early diagnosis and treatment have an extremely high importance for the further course of this disease. As a rule, the mother suffers from severe fever and pain in the uterus due to the amnioinfection syndrome. If these symptoms occur during pregnancy, a doctor must be contacted in any case. In this case, the amnioinfection syndrome can be detected by a blood test. It is not uncommon for premature labor or premature rupture of the amniotic sac to occur. If these symptoms occur, an emergency physician must be notified immediately or the hospital must be visited. If the patient is unsure about the symptoms, a checkup with a gynecologist can be done. Amnioinfectious syndrome may also be responsible for the complaints if the heart rate is elevated. The further course and treatment of the disease generally depend on the current condition and progress of the pregnancy.
Treatment and therapy
When treating amniotic infection syndrome, it is necessary to balance maternal and fetal risk. It depends on the developmental stage of the fetus at which the infection occurs. The further away the expected date of birth, the more immature the child’s development. If 36 weeks of pregnancy have already passed, birth must be induced artificially without delay. This involves constant monitoring of the child’s heart rate, control of body temperature and intravenous injection of antibiotics. Antibiotic therapy must be continued after birth until the inflammatory levels have subsided. The mother is also treated with antibiotics. If amniotic infection syndrome occurs between the 28th and 36th weeks of pregnancy, lung maturation induction with cortisone may need to be performed before induction of labor, depending on the developmental status of the child. Before 28 weeks of gestation, it may be necessary to terminate the pregnancy prematurely to save the mother’s life.
Outlook and prognosis
Amniotic infection syndrome is a very serious disease that, without treatment, can lead to death in the worst cases. In this case, the affected person may die mainly due to blood poisoning, so that the life expectancy of the patient is significantly reduced in most cases.If the child survives this disease after birth, relatively severe physical and mental limitations occur in most cases. Mental limitations also occur and can significantly complicate the daily life of the affected person. Furthermore, inflammations occur in various areas of the body. In some cases, the mother may also die as a result of the amniotic infection syndrome. In this case, the mothers suffer mainly from severe fever and pain in the area of the uterus. It is not uncommon for this or the death of the child to cause significant psychological distress or depression. The treatment of the amniotic infection syndrome is carried out with the help of antibiotics and can lead to success. However, a general prediction of the course of the disease is usually not possible. In some cases, the pregnancy can also be terminated, although this can also lead to severe psychological discomfort in many patients.
Prevention
Prevention from amniotic infection syndrome is done in cases of premature rupture of membranes by constant monitoring of heart rate, body temperature, and blood inflammation levels. Regular medical monitoring is also recommended in uncomplicated pregnancy.
Follow-up care
In amniotic infection syndrome, no special options for follow-up are available to the affected child or even the mother. Usually, no special aftercare is available either, because the poisoning can be treated relatively well. The child must take antibiotics, whereby the drugs are given directly into the blood. Furthermore, artificial respiration may be necessary to keep the child alive. In most cases, amniotic infection syndrome then results in a complete recovery without complications. Early diagnosis and treatment always have a very positive effect on the further course of the disease in the case of amniotic infection syndrome. In this case, the poisoning can be diagnosed and treated even before birth. In this case, treatment with antibiotics is also possible, and care should be taken to take the antibiotics regularly. Alcohol should also be avoided. Further late sepsis can be avoided by observing hygiene standards. Likewise, in amniotic infection syndrome, contact with other affected persons can be useful, as this can often lead to an exchange of information, which can also prevent psychological discomfort.
What you can do yourself
Amniotic infection syndrome affects pregnant women and their unborn children, putting lives at risk for both. The serious inflammatory disease is an acute emergency, so patients contact an emergency physician immediately and go to a medical clinic even if they have mild symptoms. In principle, doctors also detect the disease during screening examinations for pregnant women, so that timely intervention is often still possible. This assumes that women take advantage of all the check-ups offered by their gynecologist and report any complaints. During the disease, patients remain in the hospital at best and receive intensive care from doctors and staff. The primary goal of this therapy is to prevent or intervene early in the development of sepsis in the mother or child. If sepsis develops, a cesarean section is often necessary. In general, patients try to get plenty of rest and sleep during their stay in the hospital. In most cases, the patients receive special antibiotics whose effect on the mother as well as the unborn child is constantly monitored by the doctors. After the birth, mother and child usually stay in the hospital longer than healthy birth mothers. Due to their illness, newborns are often premature babies who require appropriate care.
