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Diagnostic criteria/classification for maternal fever and triple I

Diagnostic criteria/classification for maternal fever and triple I
Diagnostic criteria/classification of triple I*
Terminology Features and comments
Maternal fever Maternal oral temperature ≥39.0°C (102.2°F) on any one occasion is a documented fever. If the oral temperature is 38.0°C (100.4°F) to 38.9°C (102.02°F), repeat the measurement in 30 minutes; if the repeat value remains at least 38.0°C (100.4°F), it is a documented fever.
Suspected triple I Maternal fever without a clear source plus any of the following:
  1. Baseline fetal tachycardia (greater than 160 beats per min for 10 min or longer, excluding accelerations, decelerations, and periods of marked variability)
  2. Maternal white blood cell count greater than 15,000 per mm3 in the absence of corticosteroids
  3. Definite purulent fluid from the cervical os
Confirmed triple I All of the above plus objective laboratory findings of infection, such as:
  1. Positive amniotic fluid Gram stain for bacteria, low amniotic fluid glucose (eg, ≤14 mg/dL), high amniotic fluid white cell count in the absence of a bloody tap (eg, >30 cells/mm3), or positive amniotic fluid culture results, or
  2. Histopathologic evidence of infection or inflammation or both in the placenta, fetal membranes, or the umbilical cord vessels (funisitis)

min: minutes; mm: millimeters.

* Triple I refers to intrauterine inflammation or infection or both.

¶ Laboratory studies on amniotic fluid should be performed on fluid obtained by amniocentesis (not vaginally). Placental histopathology is obtained after delivery.
Adapted from: Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426. DOI: 10.1097/AOG.0000000000001246. Copyright © 2016 American College of Obstetricians and Gynecologists. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
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