Chorioamnionitis most often occurs during labor, affecting as many as 10% of laboring women. When intrapartum chorioamnionitis occurs, women are at peripartal risk for endometritis, cesarean birth, and postpartum hemorrhage; and the neonate is at significant risk for sepsis, pneumonia, respiratory distress, and death. The impact is greater for preterm infants where the incidence of chorioamnionitis is nearly 30%. When chorioamnionitis is believed to be present, antibiotics are administered, but not without potential adverse consequence to the mother/fetus, as well as significantly increased healthcare cost. A number of factors increase the risk of chorioamnionitis, including use of intrauterine pressure catheters and fetal scalp electrodes, urogenital tract infections, prolonged rupture of membranes, digital vaginal examinations, and the nature of perineal hygiene. This article presents key intrapartum factors and those nursing actions that can help to reduce rates of chorioamnionitis and improve perinatal outcomes.
Perinatal nursing practices may influence a laboring woman's risk of developing chorioamnionitis.
Marie Hastings-Tolsma, PhD, CNM, FACNM, University of Colorado Denver College of Nursing Division of Women, Children & Family Health. She can be reached via e-mail at Marie.Hastings-Tolsma@ucdenver.edu.
Rachel Bernard, BS, University of Colorado Denver College of Nursing.
Mollie Gilbert Brody, BSN, RN, University of Michigan Health System.
Jennifer Hensley, EdD, CNM, WHNP, LCCE, University of Colorado Denver College of Nursing.
Kate Koschoreck, MSN, CNM, University of Colorado Denver College of Nursing.
Elisa Patterson, MS, CNM, University of New Mexico College of Nursing.
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The authors declare no conflict of interest.