Acute Chorioamnionitis

  • Phillip CoxEmail author
  • Marta C. Cohen
  • Irene B. Scheimberg


Acute chorioamnionitis comprises acute inflammation of the chorionic plate of the placenta, the amniochorial membrane and umbilical cord. Most cases are the result of acute bacterial infection of the amniotic fluid/amniotic cavity, with the potential to spread to the fetus, to initiate preterm labour or to cause maternal sepsis.

In the chorionic plate, maternal and fetal components to the inflammatory response can be recognised by histological examination. Both elements can show a range of extent and severity, which should be recorded in the histology report, either descriptively or as a grade and stage.

The fetal inflammatory component has implications for a number of serious neonatal and long-term morbidities, particularly in premature infants.


Acute chorioamnionitis Chorionic plate inflammation Infection Fetal inflammatory response Maternal inflammatory response Placenta 


  1. 1.
    Romero R, Chaiworapongsa T, Espinoza J. Micronutrients and intrauterine infection, preterm birth and the fetal inflammatory response syndrome. J Nutr. 2003;133(suppl):1668S–73S.CrossRefGoogle Scholar
  2. 2.
    Kim CJ, Romero R, Chaemsaithong P, et al. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213:S29–52.CrossRefGoogle Scholar
  3. 3.
    Kraus FT, Redline RW, Gersell DJ, et al. Placental pathology. Washington DC: Armed Forces Institute of Pathology; 2004. p. 75–115.Google Scholar
  4. 4.
    Rogers B, Abramowsky C. Placental examination. Chapter 2. In: Cohen MC, Scheimberg I, editors. The pediatric and perinatal autopsy manual. Cambridge: Cambridge University Press; 2014. p. 17–46.CrossRefGoogle Scholar
  5. 5.
    Lee SM, Romero R, Lee KA, et al. The frequency and risk factors of funisitis and histologic chorioamnionitis in pregnant women at term who delivered after the spontaneous onset of labor. J Matern Fetal Neonatal Med. 2011;24:37–42.CrossRefGoogle Scholar
  6. 6.
    Katzman PJ, Metlay L. Fetal inflammatory response is often present at early stages of intra-amniotic infection, and its distribution along cord is variable. Pediatr Dev Pathol. 2010;13:265–72.CrossRefGoogle Scholar
  7. 7.
    Roberts DJ, Celi AL, Riley LE, et al. Acute histologic chorioamnionitis at term: nearly always noninfectious. PLoS One. 2012;7:e31819.CrossRefGoogle Scholar
  8. 8.
    Cohen-Cline HN, Kahn TR, Hutter CM. A population-based study of the risk of repeat clinical chorioamnionitis in Washington State, 1989–2008. Am J Obstet Gynecol. 2012;207:473.el–7.CrossRefGoogle Scholar
  9. 9.
    Yancey MK, Duff P, Clark P, et al. Peripartum infection associated with vaginal group B streptococcal colonization. Obstet Gynecol. 1994;84:816–9.PubMedGoogle Scholar
  10. 10.
    Soper DE, Mayhall CG, Froggatt JW. Characterization and control of intraamniotic infection in an urban teaching hospital. Am J Obstet Gynecol. 1996;175:304–10.CrossRefGoogle Scholar
  11. 11.
    Newton ER, Piper J, Peairs W. Bacterial vaginosis and intraamniotic infection. Am J Obstet Gynecol. 1997;176:672–7.CrossRefGoogle Scholar
  12. 12.
    Seaward PG, Hannah ME, Myhr TL, et al. International multicentre term prelabor rupture of membranes study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol. 1997;177:1024–9.CrossRefGoogle Scholar
  13. 13.
    Rickert VI, Wiemann CM, Hankins GD, McKee JM, Berenson AB. Prevalence and risk factors of chorioamnionitis among adolescents. Obstet Gynecol. 1998;92:254–7.CrossRefGoogle Scholar
  14. 14.
    Tran SH, Caughey AB, Musci TJ. Meconium-stained amniotic fluid is associated with puerperal infections. Am J Obstet Gynecol. 2003;189:746–50.CrossRefGoogle Scholar
  15. 15.
    Malaeb S, Dammann O. Fetal inflammatory response and brain injury in the preterm newborn. J Child Neurol. 2009;24:1119–26.CrossRefGoogle Scholar
  16. 16.
    Hagberg H, Wennerholm UB, Sävman K. Sequelae of chorioamnionitis. Curr Opin Infect Dis. 2002;15:301–6.CrossRefGoogle Scholar
  17. 17.
    Ducey JR, Owen A, Coombs RC, Cohen MC. Vasculitis as part of the fetal inflammatory response to acute chorioamnionitis likely plays a role in the development of necrotising enterocolitis and spontaneous intestinal perforation in premature neonates. Eur J Pediatr Surg. 2015;25:284–91.CrossRefGoogle Scholar
  18. 18.
    Redline RW. Placental inflammation. Semin Neonatol. 2004;9:265–74.CrossRefGoogle Scholar
  19. 19.
    Khong TY, Mooney EE, Ariel I, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016;140:698–713.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Phillip Cox
    • 1
    Email author
  • Marta C. Cohen
    • 2
  • Irene B. Scheimberg
    • 3
    • 4
  1. 1.Birmingham Women’s and Children’s NHS TrustBirminghamUK
  2. 2.Sheffield Children’s Hospital NHS FTSheffieldUK
  3. 3.Queen Mary University College Medical SchoolLondonUK
  4. 4.Department of Cellular PathologyThe Royal London Hospital, Barts Health NHS TrustLondonUK

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