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Chorioamnionitis is an infection of fetal membranes and the placenta. It happens when bacteria move from the vagina into the uterus. This bacteria can then reach the child during birth. These infections cause an inflammatory response that are linked to prostaglandin release, cervical ripening, membrane trauma, and early labor.
Chorioamnionitis can be diagnosed non-invasively in a clinical setting, though laboratory tests are also available. Doctors can often prevent chorioamnionitis from being passed from mother to child if they deliver the baby early. They must also provide the mother with proper antibiotics in a timely manner in order to confer neuroprotective benefits on the child.
Villitis is the inflammation of the structures covering the surface of the placenta. These allow the baby to receive ample nutrients from the mother. Usually, this inflammation results from chorioamnionitis. But it can also stem from other bacterial or viral infections, such as Streptococci, herpes, syphilis, and rubella. If these membranes are inflamed, nutrient absorption can drop to dangerously low levels. This increases the risk of fetal death.
Typically this inflammation is undetectable, unless an abscess forms. Once this happens, it can be detected via ultrasound. The best way to avoid complications from villitis? Prevent inflammation in the first place by immediately diagnosing -- and treating -- underlying infections.
It is imperative that doctors promptly diagnose and treat chorioamnionitis and other infections that can cause villitis. If a medical professional mishandles treatment, there can be devastating consequences:
With chorioamnionitis, potentially infectious bacteria pass from the colon, cervix, and/or vagina to the uterus. This is where the baby is located. Once infected, there is an inflammatory response in both mother and child. This inflammation may cause the hormone prostaglandin, cervical ripening, injury to membranes, and labor complications.
Villitis is linked to infections of the placenta. Several conditions can cause villitis, but in the vast majority of cases, the cause is unknown.
Some bacterial causes of villitis include:
Viral causes of villitis can include:
Risk Factors for Chorioamnionitis and Villitis
An initial exam may reveal no signs or symptoms of infection. But a pregnant woman with chorioamnionitis may appear ill and show signs of hypotension, sweat excessively, and/or have cold, clammy skin. The most important sign to look for, however, is fever.
Signs and symptoms of chorioamnionitis include the following:
Signs of chronic villitis can include:
Signs of Acute villitis:
Diagnosing Chorioamnionitis and Villitis
Chorioamnionitis may be diagnosed based on maternal fever, or by microscopic exam of the umbilical cord and/or placenta. The diagnosis typically often based on clinical signs. But it is usually avoided since access to uncontaminated amniotic fluid or placenta for culture is invasive.
In general, a fever (defined as a temperature greater than 100.4 degrees) and two other signs (such as a tender uterus, fetal or maternal tachycardia, and/or foul amniotic fluid) are required for diagnosis. The presence of other risk factors, especially membrane rupture, help strengthen diagnosis.
Treatment of mother and child with chorioamnionitis includes early delivery and/or antibiotics.
Prompt administration of antibiotics is essential to prevent fetal and maternal complications. Intravenous (IV) administration of ampicillin every 6 hours and gentamicin every 8-24 hours until delivery is the standard of care. If a C-section is performed, clindamycin every 8 hours is often added for anaerobic coverage. Treatment also should include administration of a single IV additional dose of antibiotics after delivery.
Supportive measures include the use of acetaminophen (Tylenol). This is important during delivery to prevent neonatal encephalopathy.
Research has shown that when a doctor suspects villitis, steroids and aspirin can be beneficial. In most cases, the cause of villitis is unknown. However, as villitis is associated with placental infections, it is critical that these infections be diagnosed and treated immediately.
The following items may constitute negligence:
If chorioamnionitis and other placental infections are not identified and treated immediately, potentially fatal complications can arise. When this negligence causes injury to the mother or child, it is medical malpractice.
If your child experienced a birth injury resulting from mishandling of a maternal infection, the team at Willens Law Offices can help.
We have helped the families of children across Illinois get the compensation they need for a secure future. We strive to give the utmost personal attention to each child and family we represent.
Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that speak to our success and experience. You will not pay our firm unless we win or settle your case.
Call Willens Law Offices at (312) 957-4166 for a free case evaluation. Our firm’s expert team are available to you whenever you need them, 24/7.
The plaintiff went to a Chicago hospital for delivery of twins via cesarean section. In the delivery room, a suspicious rash was recognized on one of the twins and later, fecal and urine cultures confirmed the presence of candida. She was started on prophylactic anti-fungal medicine and is healthy. The other twin was clear of any rash and though she was at risk for fungal infection, she was not treated in a timely manner. Later, a head ultrasound and MRI confirmed the diagnosis and damage to her brain. A lawsuit was filed on the plaintiff’s behalf. The case was vigorously defended by lawyers for the physician and the hospital that he worked for over 3 years. Eventually, a mediation took place at which time the defendants offered $3,000,000 to settle, which the plaintiff rejected. It was not until trial that the case settled for $10,000,000.
Birth injury cases are among the most complicated medical malpractice cases to litigate. With years of experience in birth trauma litigation our legal team has the skills, the resources and experience necessary to address and win a wide variety of birth injury cases. Our legal team has secured millions of dollars in compensation for birth injury victims.
With decades of hands-on experience working with top healthcare professionals in labor and delivery, our legal team has access to some of the top medical professionals in the world. As in many types of medical malpractice cases, high quality expert are essential in obtaining justice.
Our firm was established to focus on the unique needs of our clients. We work with top medical, life-planning, and forensics experts to determine the causes and extent of injuries, prognoses of victims, and areas of medical negligence. Our passion for helping birth injury victims allows our attorneys to deliver unrivaled legal services for your family.
Willens Law Offices have helped the families of children across Illinois get the compensation they need for a secure future.
We strive to give the utmost personal attention to each child and family we represent.