Chorioamnionitis.

Chorioamnionitis is an inflammatory reaction occurring in the fetal membranes of the placenta. It is usually associated with premature rupture of the membranes, whether spontaneous or artificial. Rupture of the fetal membranes sets off a time bomb that threatens both maternal and fetal welfare. The seriousness of this threat is dependent upon several variables: the length of gestation, economic status of the patient and the duration of the rupture. There is a controversy about the relative importance of these variables and about the proper degree of aggressiveness necessary to achieve optimum fetal salvage. When chorioamnionitis occurs, most obstetricians agree that the uterus should be evacuated by the most expeditious route. Usually oxytocic induction will accomplish delivery without difficulty, but should it fail to effect cervical ripening and dilatation within a reasonable time, cesarean section should be performed without further delay. If cesarean section is necessary in the presence of gross infection, hysterectomy is advocated by some.