羊膜腔内感染是导致羊水的任何组合的炎症的感染,胎盘,胎儿本身,胎膜,脐带,或者decidua。在过去,羊膜和绒毛膜或两者的感染被称为绒毛膜羊膜炎。2015年,一个专家小组提出了一项建议,而不是临床绒毛膜羊膜炎,宫内炎症或感染或两者兼有,缩写为TripleI或简称IAI。然而,缩写IAI没有得到普及,本文使用的术语是绒毛膜羊膜炎。绒毛膜羊膜炎可能出现之前,during,或跟随劳动。它可以表现为慢性,亚急性,或急性感染。其临床表现通常被称为急性绒毛膜羊膜炎。由于不同的细菌原因和缺乏足够的证据来支持特定的治疗方案,绒毛膜羊膜炎的治疗在世界范围内差异很大。有限的随机对照试验评估了抗生素治疗分娩期间羊膜感染的优越性。缺乏循证治疗表明,目前抗生素的选择是基于现有研究的局限性,而不是绝对的科学。绒毛膜羊膜炎不能通过单独的抗生素治疗而不分娩治愈,因此,有必要根据引产或加速分娩的指南做出决定。当怀疑或确定诊断时,因此,有必要根据每个国家使用的协议应用广谱抗生素,并继续与他们,直到交付。绒毛膜羊膜炎通常推荐的一线治疗是由阿莫西林或氨苄青霉素和每日一次庆大霉素组成的简单方案。现有信息不足以表明治疗这种产科疾病的最佳抗菌方案。然而,目前可用的证据表明,患有临床绒毛膜羊膜炎的患者,主要是胎龄在34周或以上的妇女和分娩的妇女,应该接受这种制度的治疗。然而,抗生素偏好可能因当地政策而异,临床医生的经验和知识,感染的细菌原因,抗菌素耐药性模式,产妇过敏,和药物供应。
Intraamniotic infection is an infection resulting in the inflammation of any combination of the amniotic fluid, the placenta, the fetus itself, the fetal membranes, umbilical cord, or the decidua. In the past, an infection of the amnion and chorion or both was dubbed chorioamnionitis. In 2015, a proposal was made by an expert panel that, instead of clinical chorioamnionitis, the name intrauterine inflammation or infection or both be used, abbreviated as Triple I or simply IAI. However, the abbreviation IAI did not gain popularity, and this article uses the term chorioamnionitis. Chorioamnionitis may arise prior to, during, or following labor. It can present as a chronic, subacute, or acute infection. Its clinical presentation is generally referred to as acute chorioamnionitis. The treatment of chorioamnionitis varies widely across the world due to different bacterial causes and the absence of sufficient evidence to support a specific treatment regimen. There are limited randomized controlled trials that have evaluated the superiority of antibiotic regimens for treating amniotic infections during labor. This lack of evidence-based treatment suggests that the current choice of antibiotics is based on limitations in existing research, rather than absolute science. Chorioamnionitis cannot be cured by antibiotic therapy alone without delivery, and therefore it is necessary to make a decision according to the guidelines for induction of labor or acceleration of delivery. When a diagnosis is suspected or established, it is therefore necessary to apply broad-spectrum antibiotics according to the protocol used by each country, and to continue with them until delivery. A commonly recommended first-line treatment for chorioamnionitis is a simple regimen consisting of amoxicillin or ampicillin and once-daily gentamicin. Available information is not sufficient to indicate the best antimicrobial regimen to treat this obstetric condition. However, the evidence that is currently available suggests that patients with clinical chorioamnionitis, primarily women with a gestational age of 34 weeks or more and those in labor, should receive treatment with this regime. However, antibiotic preferences may vary based on local policy, clinician experience and knowledge, bacterial reasons for the infection, antimicrobial resistance patterns, maternal allergies, and drug availability.