Definition
Maternal presentation
Intra-Amniotic Infection (IAI) often occurs in women with premature rupture of membranes (PROM) but can occur with intact membranes, especially in laboring women. The key clinical findings, which are nonspecific, and their frequencies are as follows:
●Fever – T > 38 deg centigrade (100 percent).
●Maternal leukocytosis (variously defined as white blood cell count >12,000/mm3 or >15,000/mm3) (70 to 90 percent). NB: WBCs can significantly increase during normal labor.
●Maternal tachycardia >100/min (50 to 80 percent).
●Fetal tachycardia >160/min (40 to 70 percent).
●Uterine tenderness (4 to 25 percent).
●Bacteremia (5 to 10 percent). Bacteremia is most common when IAI is associated with group B Streptococcus or Escherichia coli infection (bacteremia in 18 and 15 percent of cases, respectively).
●Purulent or malodorous amniotic fluid.
IAI may be subclinical, which by definition does not present with the above clinical findings. Subclinical infection may manifest as preterm labor with intact membranes or as preterm premature rupture of membranes (PPROM).