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.

Introduction: Endometritis (EMM) is the most common maternal infectious complication of childbirth, occurring more commonly after low transverse cesarean section (LTCS) than vaginal delivery [1]. In a Cochrane review, the mean incidence of EMM following elective cesarean section was 7% and after non-elective or emergency operations was 30% [4]. A variety of independent risk factors for post-cesarean EMM have been identified in previous studies, including no prior cesarean section [5], low infant Apgar scores [6], trial of labor [7], premature rupture of membranes (PROM) >24 hours, young maternal age [8], preterm or post-term gestation [9], antepartum infections [10], pre-eclampsia, meconium [11], amnion infusion, postpartum anemia, multiple vaginal examinations [12], and manual removal of the placenta [13]. The time of ruptured membranes before delivery is examined via dichotomized time thresholds, the risks of chorioamnionitis and endomyometritis are significantly increased at 12 hours and 16 hours, respectively [16, 17]. A change in policy to administer prophylactic antibiotics before skin incision led to a significant decline in postcesarean delivery surgical-site infections [18, 19]. Objective: To determine independent risk factors for EMM following (LTCS). Material and Method: The study was case-control study, between 2022 to 2023 years at the “Urguu” specialized maternal hospital Ulaanbaatar, Mongolia. Case group has 101 women with EMM and the control group has 100 women with non EMM after LTCS. Results: The age of 2 study groups was 32.4 and 32.8, body mass index was 30 kg/m2 and 30.7 kg/ m2.Young maternal age <25 has a 22% (p=0.001, OR=4.5) influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. (p>0.05). Delivery risk factors has increases the EMM by 15% (p=0.002), labor induction by 20% (p=0.001), duration of labor >12 hours by 40% (p=0.001), PROM increased by 15% (p=0.005), meconium by 15% (p=0.005), chorioamnionitis by 15% (p=0.001). Conclusion Our study, young maternal age <25 has influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. Delivery associated risk factors are affected by the EMM after LTCS. The labor after LTCS, labor induction, PROM >12 hours, duration of labor, number of vaginal exams>4, meconium, chorioamnionitis increased by EMM. Young maternal age (<25) increased the risk of EMM attached with labor association risk factors.