Troubled waters

• Babies born prematurely as the result of AC are often ill because their lungs and other internal organs are immature; there may be a 'neonatal respiratory distress syndrome.'
• There may be a septicaemia (blood poisoning) evident in babies who have been exposed to AC.
• The bacteria themselves may also make the baby ill, of course, and pneumonia in the newborn is nearly always caused by an AC.
• Chorioamnionitis may well cause the mother to have an excessive amount of bacteria in her own blood - this, too, may lead to a premature labour and infection of her newborn infant.

• Prolonged rupture of the membranes. This is the highest risk factor, but even in some prolonged labours infection may be seen and demonstrated. The risk of infection in the newborn increases as the duration of the ruptured membranes lengthens.
• Multiple vaginal examination during labour.
• Various types of internal monitoring systems used before or during labour.

Signs and symptoms
The suspicions of a health care worker are aroused when there is some unexplained - i.e. no other source than from the womb - temperature rise in the mother-to-be, but it has been found that only some 8 to 25 mothers out of 100 with AC will have symptoms such as a fever, chills, etc. However, there may be some associated findings to suggest AC. These are:

• An increased heart rate in the mother; more than 120 beats a minute is frequent and quite significant.
• An increased foetal heart rate, which is less significant.
• Abdominal (tummy) tenderness - when demonstrated to be the womb.
• Foul-smelling liquor (amniotic fluid) or vaginal discharge.

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