Screening and managing women with chorioamnionitis in resource-constrained healthcare settings: Evidence-based recommendations

To describe the development of evidence-based recommendations on screening and managing women at risk for chorioamnionitis in resource-constrained healthcare settings. A qualitative study, using data from an integrative literature review to develop the evidence-based recommendations was conducted. The NICE guideline development principles were followed to format the recommendations, which were reviewed by expert reviewers using the AGREE II tool. Four main recommendations were developed, which were: screening by clinical signs and symptoms; screening by causative factors of chorioamnionitis; screening of obstetric history; and prevention and management of chorioamnionitis. A screening tool and algorithm based on the recommendations were also developed. Recommendations will assist midwives in identifying women at risk for chorioamnionitis and managing them before referral. The recommendations contribute to the quality care of women who are at risk for chorioamnionitis. The developed screening tool and algorithm based on the recommendations provide user-friendly guides for midwives in similar, resource-constrained settings, such as in South Africa, where these recommendations were developed. Screening using the recommended screening tool, therefore, is by far the least expensive tool when considering treatment costs and legal compensation for preventable deaths related to chorioamnionitis.