Chorioamnionitis at Term

Burke, Carol A.; Chin, Emily G.

doi:10.1097/jpn.0000000000000163

Cited by 13 publications

(15 citation statements)

References 38 publications

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“…The association between CAM and failure of epidural conversion may be explained as follows. First, the increased labor pain in a parturient with CAM may be explained by previous reports that indicate that CAM causes uterine tenderness [ 17 , 18 ], and that inflammatory mediators, such as TNF-α, released by this inflammation contribute to the severe pain [ 11 , 19 ]. Second, it may be explained by the attenuated effects of local anesthetics under inflammation [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study

et al. 2021

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Aim This study aimed to examine the association between clinically diagnosed chorioamnionitis and failed conversion of epidural labor analgesia to cesarean delivery anesthesia. Methods This retrospective, single-center cohort study, conducted in a university hospital, enrolled term parturients undergoing emergency cesarean section after induction of epidural labor analgesia between September 2015 and May 2019. For the purpose of this study, all cases were re-examined to ensure that they fulfilled the criteria of chorioamnionitis, regardless of the actual indication for cesarean section proposed by obstetricians at the time of application. The primary outcome was failure of conversion of epidural labor analgesia to cesarean delivery anesthesia. Multivariable logistic regression analysis was performed to investigate the association between chorioamnionitis and failure of anesthesia for cesarean section. Results Among the 180 parturients reviewed, 58 (43.9%) fulfilled the criteria for chorioamnionitis. Failure of epidural conversion in the chorioamnionitis (+) group was significantly higher than in the chorioamnionitis (-) group (46.6% [27/58] vs. 18.9% [14/74], crude odds ratio = 3.7, 95% confidence interval: 1.7–8.3). After adjustment for potential confounders (age, body mass index, multiparity, and duration for epidural labor analgesia), chorioamnionitis was found to be associated with failure of anesthesia for cesarean sections (adjusted odds ratio = 3.6, 95% confidence interval: 1.6–8.4). Conclusions Chorioamnionitis is associated with the failed conversion of epidural labor analgesia to cesarean delivery anesthesia.

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Section: Discussionmentioning

confidence: 99%

Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study

et al. 2021

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“…The association between CAM and failure of epidural conversion may be explained as follows. Firstly, the increased labor pain in a parturient with CAM may be explained by previous reports that indicate that CAM causes uterine tenderness [15,16] and that in ammatory mediators such as TNFα released by this in ammation contribute to the severe pain [17]. Secondly, it may be explained by the attenuated effects of local anesthetics under in ammation [18].…”

Section: Discussionmentioning

confidence: 99%

Association of Chorioamnionitis With Failed Conversion of Epidural Labor Analgesia to Cesarean Delivery Anesthesia: a Retrospective Cohort Study

Katakura

Nagamine

Goto

et al. 2020

Preprint

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Background: This study examined the association between clinically diagnosed chorioamnionitis and failed conversion of epidural labor analgesia to cesarean delivery anesthesia.Methods: This retrospective cohort study, conducted in a single-center university hospital, enrolled term parturients undergoing emergency cesarean section after induction of epidural labor analgesia between September 2015 and May 2019. For the purpose of the study, all cases were re-examined to ensure that they fulfilled the criteria of chorioamnionitis, regardless of the actual indication for cesarean section proposed by obstetricians at the time of application. The primary outcome was failure of conversion of epidural labor analgesia to cesarean delivery anesthesia. Multivariable logistic regression analysis was performed to investigate the association between chorioamnionitis and failure of anesthesia for cesarean section.Results: Among the 180 parturients, it was found that 58 parturients (43.9%) fulfilled the criteria of chorioamnionitis. Failure of epidural conversion in the chorioamnionitis (+) group was significantly higher than that in the chorioamnionitis (-) group (46.6 % [27/58] vs. 18.9% [14/74], crude odds ratio = 3.7, 95% confidence interval 1.7-8.3). After adjustment for potential confounders (age, body mass index, multiparity, and duration for epidural labor analgesia), chorioamnionitis was found to be associated with failure of anesthesia for cesarean sections (adjusted odds ratio = 3.6, 95% confidence interval 1.6-8.4). Conclusions: Chorioamnionitis is associated with the failed conversion of epidural labor analgesia to cesarean delivery anesthesia.

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“…Maternal hyperthermia almost always exists in clinical chorioamnionitis (95-100%) and represents the most important clinical sign. However, it is an accurate indicator of a proven infection in the microbiological form in only 30% of cases [113,114]. This finding indicates that not every hyperthermia is of infectious etiology, although the perinatologist can start the treatment with antibiotics in presence of hyperthermia [113].…”

Section: Clinical Chorioamnionitismentioning

confidence: 99%

“…The reason for the hyperthermia during delivery may be a consequence of the applied epidural anesthesia. In these circumstances, there is an increase in vaginal temperature at a rate of 10°C every 7 hours [113,115]. The exact mechanism of epidural anesthesia on hyperthermia occurrence remains unknown, but it is assumed that sympathetic blockade of thermoregulatory processes underlied it [14].…”

Section: Clinical Chorioamnionitismentioning

confidence: 99%

The Chorioamnionitis - Still an Enigma in Perinatology

Varjacic,

Jovic

2024

Experimental and Applied Biomedical Research (EABR)

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Chorioamnionitis is one of the most common causes of preterm premature rupture of fetal membranes and consequent preterm birth. The variety of mechanisms underlie pathophysiology of chorioamnionitis represents its greatest enigma. The unspecific clinical manifestations of chorioamnionitis considered an aggravating issue for perinatologist to diagnose it timely. There are no absolutely sensitive, non-invasive diagnostic procedures for certain establishment of chorioamnionitis diagnosis. The more sensitive diagnostic procedures are also invasive, so the question of their application in routine practice arises. Certainly, the perinatologist is always in a dilemma when there is a suspicion of chorioamnionitis, whether and how it should be treated, having in mind the facts about possible side effects on the fetus, but also on the mother. This paper presents a summary of all known facts about the etiopathogenesis, classification and clinical manifestations of chorioamnionitis, providing a basis for further research regarding the identification of more sensitive diagnostic markers, as well as the treatment of this condition.

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Chorioamnionitis at Term

Cited by 13 publications

References 38 publications

Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study

Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study

Association of Chorioamnionitis With Failed Conversion of Epidural Labor Analgesia to Cesarean Delivery Anesthesia: a Retrospective Cohort Study

The Chorioamnionitis - Still an Enigma in Perinatology

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