DRG Category: 765
Mean LOS: 5.2 days
Description SURGICAL: Cesarean Section with CC or Major CC
DRG Category: 775
Mean LOS: 2.3 days
Description MEDICAL: Vaginal Delivery without Complicating Diagnoses
Chorioamnionitis, or intra-amniotic infection (IAI), is an infection of the chorion, amnion, and amniotic fluids that surround the fetus and is characterized by monomorphonuclear and polymorphonuclear leukocytes invading the membranes. Leukocytes in the membranes are maternal in origin; leukocytes in the amniotic fluid (amnionitis) or in the umbilical cord (funisitis) are fetal in origin. Subsequently, the fetus also becomes infected. Chorioamnionitis, which can occur with subtle or acute signs and symptoms, can happen at any time during the prenatal or intrapartal period. It occurs in 0.5% to 10% of all pregnancies and 0.5% to 2.0% of term pregnancies, most commonly after premature rupture of the membranes. Chorioamnionitis can also cause premature rupture of the membranes and preterm labor. If left untreated, it can lead to maternal sepsis or fetal demise. In fact, chorioamnionitis is associated with a neonatal mortality rate of 1% to 4% for term infants and up to 10% for preterm infants.
The prognosis for the mother with chorioamnionitis is good. Once the baby is delivered, the source of infection is removed. Rarely does chorioamnionitis lead to septic shock. Occasionally, pelvic inflammatory disease can develop if the infection is not totally resolved. The prognosis for the infant varies depending on the degree of infection that is transmitted to the fetus. Occasionally, no signs of infection develop in the infant, but this is not typical. Another factor involved in the infant's prognosis is prematurity; for the very premature infant, the risk of respiratory distress syndrome may be even greater than the risk of infection.