O41.1235 Chorioamnionitis, third trimester, fetus 5

Name of the Condition

• Chorioamnionitis, Third Trimester, Fetus 5 (ICD Code: O41.1235)

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 is typically based on clinical criteria, including maternal fever, uterine tenderness, and fetal tachycardia, often confirmed by laboratory tests (e.g., elevated maternal white blood cell count) or amniotic fluid analysis. Imaging or cultures may be used to identify pathogens. Documentation should specify the trimester and affected fetus when applicable.

Treatment Options

Treatment usually involves intravenous antibiotics to target common pathogens, with close monitoring of maternal and fetal status. Delivery may be recommended if the infection is severe or if the fetus is at risk. Supportive care, such as hydration and fever management, is also provided.

Prognosis and Follow-Up

With prompt treatment, outcomes for both mother and fetus can improve, though complications may still occur. Follow-up care includes monitoring for infection recurrence and assessing fetal well-being. Long-term prognosis depends on the severity of the infection and any resulting complications.

Complications

• Preterm birth
• Neonatal sepsis or pneumonia
• Maternal postpartum infection
• Fetal distress or stillbirth
• Chronic lung disease in the newborn (if preterm)

Lifestyle & Prevention

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

When to Seek Professional Help

Contact a healthcare provider immediately if experiencing fever, abdominal pain, or reduced fetal movement during pregnancy, as these may indicate chorioamnionitis or other complications.

Tips for Medical Coders

Use this code when documenting chorioamnionitis in the third trimester affecting the fifth fetus in a multiple gestation. Ensure clinical documentation specifies the trimester and fetus number to support accurate coding. Verify that the infection is confirmed by clinical or laboratory findings.