iMedPub Journals www.imedpub.com 2020 Vol.6 No.4:27 Case Report 1 © Under License of Creative Commons Attribution 3.0 License | This article is available in: http://gynecology-obstetrics.imedpub.com/ Gynaecology & Obstetrics Case report ISSN 2471-8165 DOI: 10.36648/2471-8165.6.4.107 Received: August 29, 2020; Accepted: September 23, 2020; Published: September 30, 2020 Chorioamnionis and Sepsis in Pregnant Woman with Vaginal Prolapse of Intact Amnioc Membranes; Maternal and Fetal Outcome: A Case Report Abstract Aim: To describe chorioamnionis and sepsis caused by uncommon germs. Case report: A healthy 28-year old woman, 23 weeks pregnant,admitted to our Hospital for risk of preterm delivery due to cervical incontinence with vaginal prolapse of intact amniotic membranes. Results: The amnioc fluid was posive for Citrobacter freundii. Blood cultures were posive for Citrobacter braaki and Morganella morganii. Conclusion: These findings indicate that ascension from the lower genital tract could be the primary pathway for intra-amnioc infecon. It could be useful to collect a sample of the amnioc fluid and/or blood culture, and administer mely a broad spectrum anbioc therapy to prevent sepsis. Keywords: Chorioamnionis; Prolapse of intact membranes; Sepsis; Pregnancy; Preterm birth Introducon Chorioamnionis is an acute inflammatory reacon of the membranes, placenta and the amnioc fluid which can lead to preterm birth and it’s usually related to poor maternal and foetal outcomes [1-4]. It is oſten caused by a microbial invasion of the amnioc membrane before or during labour especially when rupture occurs, but it can unfrequently happen with intact membranes [5]. Chorioamnionis is due to inflammatory response of the immune system following the microbial colonizaon of the amnioc sac. The more severe the inflammatory response syndrome, the more unfavourable the outcomes [6]. It has been proven that this intra amnioc infecon is commonly linked to ascending pathogens for the lower genitourinary tract to the inferior pole of the membranes [7,8]. Incidence is higher in preterm delivery rather than term labour, given that it occurs in 0.5% and 10% of preterm pregnancies, and between approximately 0.5% and 2% of term pregnancies. The detecon of chorioamnionis is found in 40% to 70% of spontaneous preterm labours and p-PROMs [3,9]. Definion of chorioamnionis itself, is made by clinical, microbiological or histopathological findings, it is defined as inflammatory syndrome characterized by fever (T > 38.0°C) in addion on one of the following criteria: leucocytosis (>15000 wbc), maternal or foetal tachycardia, uterine tenderness orfoul odour of the amnioc fluid [10]. Clinical evidence along with typical symptoms are generally what lead to the diagnosis. In this report, we had not only clinical and microbiological evidence of fluid/membranes contaminaon, but also confirmed histopathological diagnosis. Case Report On June 8 th 2019 a healthy 28-year old woman, 23 weeks pregnant, has been admied to our Hospital for risk of preterm delivery due to cervical inconnence with vaginal prolapse of intact amnioc membranes. Paent’s anamnesis was posive for thrombophilia due to both MTHFR homozygous and factor V Leiden’s heterozygous mutaons. She had history of a previous aboron in the first trimester and underwent surgical uterine cureage in 2016. She denied the assumpon of any drug but mulvitamins ad folic acid and referred no other symptoms or Petruzziello L, Scudo M, Logoteta A*, Galli V, Mondo A, Di Pinto A, Piccioni MG, Monti M, Galoppi P and Brunelli R Department of Maternal and Child Health and Urological Sciences, “Sapienza” University of Rome, Rome, Italy *Corresponding author: Logoteta A  alessandra.logoteta@uniroma1.it Department of Maternal and Child Health and Urological Sciences, “Sapienza” University of Rome, Rome, Italy. Tel: 3356347860 Citaon: Petruzziello L, Scudo M, Logoteta A, Galli V, Mondo A, et al. (2020) Chorioamnionis and Sepsis in Pregnant Woman with Vaginal Prolapse of Intact Amnioc Membranes; Maternal and Fetal Outcome: A Case Report. Gynecol Obstet Case Rep Vol.6 No.4:27