Obstetrix Medical Group of Colorado, 2055 High Street, Suite 230, Denver, CO 80205, USA.
Semin Fetal Neonatal Med. 2012 Feb;17(1):46-50. doi: 10.1016/j.siny.2011.09.002. Epub 2011 Oct 1.
Acute chorioamnionitis or intra-amniotic infection is defined by maternal fever in association with at least one additional clinical criterion including maternal or fetal tachycardia, maternal leukocytosis, uterine tenderness, or foul amniotic fluid odor. In clinically uncertain cases, the diagnosis can be augmented by routine laboratory studies (e.g. white blood cell count and differential count and acute phase reactants) and assays done on amniotic fluid. In general, the clinical management of chorioamnionitis is based on observational or cohort studies; only a few randomized controlled trials have been done. Prompt administration of antibiotics and delivery decrease maternal and neonatal morbidity. The most commonly used antibiotic regimen is ampicillin and gentamicin. Recent evidence supports daily rather than three-times-daily dosing of gentamicin for greater efficacy and decreased fetal toxicity. There is no evidence demonstrating harm with the administration of corticosteroids (to promote fetal lung maturity) in women with acute chorioamnionitis. Cesarean delivery should be reserved for standard obstetric indications.
急性绒毛膜羊膜炎或羊膜内感染定义为母亲发热，伴有至少一项附加临床标准，包括母体或胎儿心动过速、母体白细胞增多、子宫压痛或羊水有臭味。在临床情况不确定的情况下，可通过常规实验室研究（例如白细胞计数和分类计数以及急性期反应物）以及羊水检测来增强诊断。一般来说，绒毛膜羊膜炎的临床管理基于观察性或队列研究；仅进行了少数随机对照试验。及时给予抗生素和分娩可降低母婴发病率。最常用的抗生素方案是氨苄西林和庆大霉素。最近的证据支持每日而非每日三次给予庆大霉素以提高疗效并降低胎儿毒性。没有证据表明在患有急性绒毛膜羊膜炎的女性中给予皮质类固醇（促进胎儿肺成熟）会造成伤害。剖宫产应保留用于标准产科指征。
