Chorioamnionitis and Cerebral Palsy

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Chorioamnionitis and cerebral palsy may result when a pregnant woman develops an infection. With good healthcare and monitoring for risk factors, these infections should be mostly preventable. If a doctor makes a mistake and doesn’t treat the infection, a child may end up with a lifelong disability.

What Is Chorioamnionitis?

Chorioamnionitis is an infection that occurs during some pregnancies. Bacteria can cause the infection in one or more of four areas:[1]

• Amnion. This thin, tough membrane surrounds and covers a developing embryo and fetus.
• Chorion. The chorion is another membrane. It’s outside the amnion. The chorion contributes to the development of the placenta.
• Amniotic fluid. This is a protective liquid surrounding the fetus within the amnion.
• Placenta. The placenta is the temporary organ that forms in the uterus to provide oxygen and nutrients to the developing fetus.

Chorioamnionitis can be clinical or histologic. Clinical means that the symptoms indicate an infection or inflammation. Histologic refers to an infection detected when pathologists examine cell samples. Histologic chorioamnionitis may not cause any symptoms.

Is Chorioamnionitis Common?

According to research, chorioamnionitis occurs in 1% to 4% of pregnancies. The variation results from measuring different populations or groups of women with varying risk factors. The incidence of the infection rises to 40% to 70% of preterm births.[2]

Does Chorioamnionitis Cause Cerebral Palsy?

Cerebral palsy is caused by brain damage or, less commonly, abnormal brain development. There are many potential underlying causes of fetal brain damage.

Chorioamnionitis may cause cerebral palsy by depriving the fetus or baby of oxygen for a period of time. This leads to brain damage that may cause lifelong disability. The sooner the infection is detected and managed, the lower the risk of such complications.

The Signs and Symptoms of Chorioamnionitis

There are several characteristic symptoms and diagnostic criteria for chorioamnionitis:[3]

• Fever in the mother
• Rapid heart rate in the fetus or mother, or both
• A high white blood cell count in the mother
• Unusual vaginal discharge
• Tenderness or pain in the uterus

Some women have mild or no symptoms. In these cases, the infection may not be diagnosed until labor begins early or there are other complications. Diagnosing it during labor and delivery increases the risk of neonatal sepsis, a severe infection in the baby that can be fatal.

To diagnose chorioamnionitis, doctors look at a mother’s and fetus’s symptoms. If troubling, they will order blood tests to look for bacteria and other signs of infection. They may also sample the amniotic fluid for testing.

What Causes Chorioamnionitis?

The cause of chorioamnionitis is a maternal bacterial infection. It moves from the urinary tract into the uterus and the amniotic sac. The infection may originate in the rectum or vagina and move into the urinary tract.

The bacteria that cause this infection include Ureaplasma urealyticum, Mycoplasma hominis, E. coli, anaerobic bacteria, and group B streptococci. The infection is often a result of multiple bacterial types.

What Are the Risk Factors?

The underlying cause of the condition is an infection with bacteria. How exactly the infection begins is not always known. Certain risk factors make it more likely to develop:[2]

• Low maternal age
• Low socioeconomic status
• First pregnancy
• Smoking, drinking, or drug use
• A weakened immune system
• Sexually transmitted infections
• Multiple vaginal exams
• Internal monitoring of the fetus
• Prolonged labor
• Ruptured membranes for an extended period of time

How Do Doctors Treat Chorioamnionitis?

If doctors find signs of an infection, they may prescribe antibiotics. The sooner a mother is treated, the lower the risk and severity of complications.

In some cases of chorioamnionitis, doctors will deliver the baby as soon as possible, often by Cesarean section. If the baby is born with the infection, they will also receive antibiotics.

It’s important to treat symptoms as well, especially fever. The mother may receive medications to lower her fever and reduce the risk of neurological complications.

Complications of Chorioamnionitis

In the mother, the infection can cause:

• Additional infections, including in the bloodstream
• Pelvic abscesses
• Hemorrhage
• Blood clots
• Endomyometritis, a serious infection that can cause maternal mortality

Complications may also occur in the baby and are often more serious, even fatal:

• Neonatal sepsis is a severe infection that can be fatal
• Fetal inflammatory response syndrome
• Pneumonia
• Meningitis

How Does Chorioamnionitis Cause Cerebral Palsy?

Chorioamnionitis can also cause long-lasting complications and disabilities in babies. This may occur if the infection results in asphyxia and brain damage. One of the most common lasting complications is cerebral palsy.

The risk of cerebral palsy and other disabilities is higher if the baby is preterm. Even in babies delivered at or near term, chorioamnionitis increases the risk of cerebral palsy four-fold.[2]

Is Chorioamnionitis Preventable?

Not all cases of chorioamnionitis are preventable. However, doctors should detect the signs of an infection in time to manage it and reduce the risk of complications to the mother and the baby.

Mothers and their doctors should be aware of risk factors. If the mother has risk factors, the doctor can monitor her regularly for signs of infection and take steps to treat it if necessary.

Can Medical Malpractice Cause Complications of Chorioamnionitis?

Medical professionals can’t always prevent these infections. Sometimes, they may do everything right, but an infection still occurs and causes complications.

It is also possible that a doctor makes mistakes that result in a worsening or untreated infection, such as failing to:

• Note risk factors or act to mitigate them as much as possible
• Diagnose an infection or diagnose it too late
• Treat an infection appropriately, or at all, once detected
• Deliver the baby immediately if signs indicate it is warranted
• Treat an infected infant right away after birth or provide appropriate treatments

Getting Legal Help for Cerebral Palsy Caused by Chorioamnionitis

If you had chorioamnionitis and now your baby has complications or long-term disabilities, like cerebral palsy, you may be wondering if medical malpractice is to blame.

Contact a birth injury lawyer with experience holding doctors accountable for negligence. The right lawyer can examine your case and determine if negligence likely played a role.

If they believe your doctor or another health professional committed malpractice, they can advise you on what to do next. This may include filing a lawsuit to seek compensation.

Chorioamnionitis is a serious condition with potentially life-changing consequences. Your doctor is responsible for providing the best possible care; if they fail, a lawyer could help you get results.