O41.142 Placentitis, second trimester

Name of the Condition

• Placentitis, Second Trimester (ICD Code: O41.142)

Summary

Placentitis in the second trimester is an inflammatory condition affecting the placenta during weeks 13 to 26 of pregnancy. This condition typically results from infection and can compromise placental function, potentially impacting maternal and fetal health. Timely diagnosis and management are essential to mitigate risks such as preterm labor or fetal distress.

Causes

Placentitis often arises from ascending bacterial or viral pathogens from the vaginal tract, though hematogenous spread (via the bloodstream) or direct contamination can also occur. Common pathogens include group B streptococcus, Escherichia coli, and other organisms associated with genitourinary infections. Risk increases with prolonged rupture of membranes or invasive prenatal procedures.

Risk Factors

• Prolonged rupture of membranes (especially >18 hours)
• Multiple vaginal examinations during labor
• Preterm labor or delivery
• Maternal genitourinary infections
• Invasive prenatal procedures
• Immunocompromised maternal status

Symptoms

• Maternal fever or chills
• Uterine tenderness
• Foul-smelling vaginal discharge
• Fetal tachycardia
• Maternal leukocytosis
• Abdominal pain or cramping

Diagnosis

Diagnosis typically involves clinical evaluation of maternal symptoms, laboratory testing (e.g., elevated white blood cell count, C-reactive protein), and ultrasound to assess placental integrity. Amniocentesis may be used to detect infection markers in amniotic fluid.

Treatment Options

Treatment typically includes antibiotics to target the underlying infection, with close monitoring of maternal and fetal status. In severe cases, hospitalization or delivery may be necessary to prevent complications.

Prognosis and Follow-Up

Prognosis depends on the severity of the infection and timely intervention. Close follow-up with regular monitoring of maternal and fetal health is essential to manage potential complications and ensure optimal outcomes.

Complications

• Preterm labor or delivery
• Fetal distress or growth restriction
• Maternal sepsis
• Placental abruption
• Neonatal infection

Lifestyle & Prevention

• Practice good prenatal hygiene to reduce infection risk.
• Avoid unnecessary vaginal examinations.
• Report any unusual symptoms (e.g., fever, discharge) promptly.
• Follow provider guidance on prenatal care and testing.

When to Seek Professional Help

Seek immediate medical attention if experiencing fever, uterine tenderness, foul-smelling discharge, or fetal movement changes.

Tips for Medical Coders

Document the trimester (second trimester) and any relevant clinical details to support the use of O41.142. Ensure specificity in coding by confirming the timing of the condition and excluding other trimester-specific codes.