Revisiting the Diagnostic Criteria of Clinical Chorioamnionitis in Preterm Birth

(BJOG. 2017;124(5):775–783) Although maternal fever has long been considered a distinguishing feature in the clinical diagnosis of chorioamnionitis, studies have indicated that maternal fever does not have high sensitivity in the prediction of neonatal infectious morbidities, such as early-onset neonatal sepsis (EONS). Because undiagnosed clinical chorioamnionitis can cause serious adverse neonatal outcomes, including neonatal sepsis and perinatal death, it is crucial to be able to predict early-onset neonatal infection as accurately as possible. Several recent studies have attempted to determine sensitive markers of infection. However, there has been little research on the differential effects of fever as a criterion for the diagnosis of clinical chorioamnionitis in women with preterm prelabor rupture of membranes (PPROM) or preterm labor (PTL), a subgroup of patients who have typically received antibiotics as part of their usual management.