Which infection is of particular concern after rupture of membranes?

• A. Chorioamnionitis
• B. Preeclampsia
• C. Ectopic pregnancy
• D. Placenta previa

Answer: (A)

When membranes rupture, the protective barrier between the vagina and the intrauterine environment is breached, making it easier for bacteria to ascend into the amniotic cavity. The infection that most directly concerns this situation is chorioamnionitis, an infection of the fetal membranes (chorion and amnion) and often the placenta. This condition can develop quickly after rupture and carries risks for both the mother and the fetus, including fever, uterine tenderness, fetal or maternal tachycardia, and often foul-smelling amniotic fluid. Prolonged rupture of membranes increases this risk because the longer the barrier is open, the more time bacteria have to ascend.

Preeclampsia, ectopic pregnancy, and placenta previa are not primarily caused by rupture of membranes. Preeclampsia is a hypertensive disorder of pregnancy, an ectopic pregnancy occurs when implantation happens outside the uterus, and placenta previa involves placenta placement over the cervix and bleeding risk.