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Related Experiment Videos

Emphysematous chorioamnionitis diagnosed by ultrasonography

P Wein1, C Bass

  • 1University of Melbourne, Department of Obstetrics and Gynecology, Australia.

American Journal of Perinatology
|May 1, 1997
PubMed
Summary

This case highlights a severe chorioamnionitis in a patient with preterm labor, emergency cervical cerclage, and diabetes. The combination led to intra-amniotic gas and sepsis, emphasizing the need for infection screening before cerclage.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Infectious Diseases in Pregnancy

Background:

  • Preterm labor, cervical cerclage, and diabetes mellitus are known risk factors for chorioamnionitis.
  • The synergistic effect of these conditions on infection severity is not well-documented.

Observation:

  • A patient with a history of abortions underwent emergency cervical cerclage for preterm labor at 24 weeks.
  • Intra-amniotic gas was detected ultrasonographically the following day, indicating severe infection.

Findings:

  • The patient presented with purulent cervical discharge, neutrophilia, and elevated C-reactive protein, confirming chorioamnionitis.
  • Escherichia coli was isolated, and the infant succumbed to complications of prematurity and sepsis.
  • The patient was later diagnosed with gestational and permanent diabetes mellitus.

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Implications:

  • The combination of chorioamnionitis, diabetes, and intact membranes can result in severe infection with intra-amniotic gas production.
  • Pre-procedure infection screening is crucial before performing emergency cervical cerclage, particularly in patients with diabetes mellitus.