O41.1230 Chorioamnionitis, third trimester, not applicable or unspecified

Name of the Condition

• Chorioamnionitis, Third Trimester, Not Applicable or Unspecified (ICD Code: O41.1230)

Summary

Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid during pregnancy. This condition involves microbial invasion, typically bacterial, and can affect both maternal and fetal health. It is often associated with inflammation and may lead to complications if not managed promptly. The infection can occur at any stage of pregnancy but is more common in the second or third trimester.

Causes

The infection usually results from bacteria ascending from the vaginal tract into the uterus, though hematogenous spread (via the bloodstream) or direct contamination can also occur. Common pathogens include group B streptococcus, Escherichia coli, and other vaginal flora. Risk increases with prolonged rupture of membranes or invasive procedures during pregnancy.

Risk Factors

• Prolonged rupture of membranes (especially >18 hours)
• Multiple vaginal examinations during labor
• Preterm labor or delivery
• Maternal infections (e.g., urinary tract infections)
• Low socioeconomic status or limited prenatal care
• History of prior intrauterine infections

Symptoms

• Maternal fever (≥38°C or 100.4°F)
• Maternal tachycardia (≥100 beats per minute)
• Fetal tachycardia (≥160 beats per minute)
• Uterine tenderness
• Foul-smelling amniotic fluid (if membranes are ruptured)

Diagnosis

Diagnosis relies on clinical evaluation of maternal symptoms, laboratory testing for infection markers (e.g., elevated white blood cell count), and ultrasound to assess amniotic fluid and fetal status. Amniocentesis may be used for culture if membranes are ruptured.

Treatment Options

Treatment typically involves intravenous antibiotics to target common pathogens, such as penicillin or clindamycin, often administered until delivery. Close monitoring of maternal and fetal status is essential, and delivery may be recommended if the infection is severe or if fetal distress is present.

Prognosis and Follow-Up

With prompt treatment, outcomes for both mother and baby can improve, though complications may still occur. Follow-up care includes monitoring for postpartum infections and assessing neonatal health, as infants may require antibiotics or supportive care.

Complications

• Maternal sepsis or endometritis
• Preterm birth
• Fetal distress or stillbirth
• Neonatal sepsis or pneumonia
• Long-term developmental issues in the infant

Lifestyle & Prevention

• Attend regular prenatal care to monitor for infections
• Avoid unnecessary vaginal examinations during pregnancy
• Seek prompt treatment for genitourinary infections
• Follow guidelines for membrane rupture management

When to Seek Professional Help

Contact a healthcare provider immediately if experiencing fever, uterine tenderness, or foul-smelling vaginal discharge during pregnancy, as these may indicate chorioamnionitis.

Tips for Medical Coders

Use this code for chorioamnionitis diagnosed in the third trimester when the specific trimester or applicability is not documented. Ensure documentation supports the diagnosis and trimester to justify code assignment.