INTRA UTERINE INFECTIONS
Intrauterine infection is infection within the womb. Research suggests that intrauterine infection may be responsible for as many as 40 percent of preterm births.
The womb, amniotic fluid and the environment in which the baby develops is normally sterile but sometimes micro-organisms find their way into this environment. These are usually natural bacteria, harmless normally, but have migrated to parts of the body where they shouldn’t be. The most common cause of intrauterine infection is through the vagina and cervix, but it can also come through the placenta, through the fallopian tubes or via invasive procedures such as amniocentesis.
Infections that could ascend to the womb include E-Coli and Group B Streptococcus (GBS), bacterial vaginosis, chlamydia, trichomona, gonorrhoea, syphilis and HIV (but not thrush).
If the infection reaches the womb it can cause the fetal membranes (membrane of the sac that surrounds your baby in the womb) to become inflamed and infected. This is called chorioamnionitis.
This is an infection of the membranes of the sac that holds your baby and the waters, and usually occurs when an undetected infection progresses up into the womb. The infection causes the membranes to become inflamed and this may in itself trigger preterm contractions. It could also cause the waters to break early (also known as preterm premature rupture of the membranes, or PPROM for short). When an infection causes PPROM the waters are no longer sterile. Your baby may need to be born soon to prevent a more serious infection.
PREMATURE RUPTURE OF MEMBRANES (PPROM)
Premature rupture of membranes (PROM) is the rupture of the membranes prior to the onset of labour.
Most women go into spontaneous labour within 24 hours of rupturing their membranes, but 6% of women will not be in spontaneous labour within 96 hours. However, the earlier in gestation the rupture occurs, the less likely that the onset of labour will be within a specified time period.
PROM occurs in 6-19% of term pregnancies.
PPROM occurs in 2% of all pregnancies.
PPROM is associated with 40% of preterm deliveries and can lead to significant morbidity and mortality.
Risk Factors for PPROM
- Smoking. Heavy cigarette smoking increases the risk of PPROM more at early gestational age than at term.
- Previous preterm delivery.
- Vaginal bleeding (at any time during the pregnancy).
- There is an association between lower genital tract infection and PPROM.
- Around a third of women with PPROM have positive amniotic fluid cultures.
The mother may give history of a ‘popping sensation’ or a ‘gush’ with continuous watery liquid draining thereafter. Their underwear or pad may be damp.
BACTERIAL VAGINOSIS (BV) OR VAGINITIS
BV happens when bacteria in the vagina become overgrown and cause an infection. Signs of BV include a white-yellow discharge from the vagina, itching around the vagina or burning when you go to the bathroom. If you have these signs, you should call your healthcare provider. BV should be treated with antibiotics.
Source: www.kfap.org (PDF Document)
URINARY TRACT INFECTIONS
Often caused by the E-Coli bug, UTIs affect about five percent of pregnant women. In between one third and a half of those women, the UTI will travel up into the kidneys, causing acute pyelonephritis, a kidney infection that can cause premature labour and low birthweight. Watch out for these symptoms of UTIs:
- High fever
- Pain in your sides or lower back
- Discomfort or pain when passing urine
If you have any of these symptoms, contact your healthcare team as soon as possible as you may need antibiotics.