Detection of chorioamnionitis in pregnant women using the TRIPLE I criteria
- VernacularTitle:Жирэмсэн эмэгтэйчүүдийн умай доторх халдварыг “TRIPLE I” шалгуураар илрүүлсэн нь
- Author:
Selenge D
1
;
Lkhagva-Ochir E
2
;
Bolorchimeg B
1
Author Information
1. Department of Obstetrics and Gynecology, School of Medicine, MNUMS
2. State Maternity Hospital, Ulaanbaatar
- Publication Type:Journal Article
- Keywords:
Fever;
Gestational Age;
Histopathology
- From:
Mongolian Journal of Health Sciences
2026;92(2):49-53
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Chorioamnionitis, defined as an infection of the chorionic and amniotic membranes, is a significant contributor to maternal and neonatal morbidity and mortality. The condition triggers an inflammatory immune response between the mother and fetus, thereby increasing the risk of preterm delivery and neonatal infection. Globally, chorioamnionitis occurs in approximately 2–4% of term deliveries and 40–70% of preterm births, with an inverse relationship to gestational age. In 2015, an expert panel led by the U.S. National Institute of Child Health and Human Development recommended replacing the term “chorioamnionitis” with the broader concept of intrauterine infection or inflammation, abbreviated as “Triple I,” and proposed diagnostic criteria based on six clinical indicators.
Aim:To identify intrauterine infection (chorioamnionitis) among pregnant women using the “Triple I” diagnostic criteria.
Materials and Methods:A retrospective study was conducted using medical records from women who delivered at Urguu Maternity Hospital in 2024. Data were collected from archival records, including clinical signs, physical examination findings, laboratory results, and histopathological analyses, in accordance with the “Triple I” criteria established by the U.S. National Institute of Child Health and Human Development. Of the total 5,838 deliveries recorded in 2024, 326 cases were selected and analyzed.
Result:The mean age of the pregnant women included in the study was 31.5±6.4 years (range: 15–44 years). Of all births, 91.1% were preterm and 8.9% were term. Gestational age ranged from 28 to 44 weeks, with a mean of 35.1±1.7 weeks and an additional 2.5±2.1 days. Among the 29 term mothers diagnosed with chorioamnionitis, 38% developed fever during labor or in the postpartum period, whereas 62% had no history of fever. According to the “Triple I” criteria for intrauterine infection, fever was observed in 17 cases (5.2%), while 6 cases (35.3%) were classified as suspected. Among the suspected cases, placental histopathological examination confirmed inflammation and infection in 1 case (5.8%), thereby establishing the diagnosis of chorioamnionitis. Comparison of preterm and term mothers based on the “Triple I” criteria showed that clinical signs were less pronounced in preterm births; however, infection progression and diagnostic confirmation were more frequent compared with term births.
Conclusion:1. Chorioamnionitis was suspected in 5.2% of pregnant women, with histopathological confirmation in approximately one in seven cases.
2. Based on the “Triple I” criteria, clinical manifestations were more frequently observed in term mothers, whereas chorioamnionitis was more commonly confirmed by placental histopathology in preterm mothers.
- Full text:2026092615294458669.pdf
