The changing perinatal and maternal outcome in chorioamnionitis.

Chorioamnionitis is difficult to detect clinically, but its recognition in those at risk is essential. A retrospective study of 140 patients from among 26,129 deliveries was conducted over a 2-year period. The findings suggest that in modern obstetric practice, both perinatal and maternal complications associated with chorioamnionitis (particularly sepsis) are infrequent problems. Four neonatal deaths occurred but no infants died of sepsis. There were no maternal deaths, but 38 patients developed postpartum infections. Cesarean section did not appear to improve either perinatal or maternal outcome. With the use of appropriate modern antibiotics, extraperitoneal cesarean section and cesarean hysterectomy are probably no longer indicated. Not all neonates born out of a microbiologically contaminated intrauterine environment required antibiotic therapy, however, and individualization is recommended.