Villitis is inflammation of the chorionic villi, which are the structures covering the surface of the placenta that ensure the baby receives enough nutrients and gases from the mother. This inflammation can stem from chorioamnionitis or other infectious agents such as Streptococci, herpes, rubella and syphilis. Often, however, the cause is unknown. If these membranes are inflamed, the rate at which nutrients and gases can be exchanged drops significantly. Usually this inflammation is undetectable unless abscesses begin to form. Once they begin to form, they can be detected with an ultrasound test. The best way to avoid complications from villitis is to prevent inflammation in the first place by immediately diagnosing and treating any underlying infections that can trigger it.
Causes of Villitis
Villitis is associated with placental infections. There are several conditions that can cause villitis, but in many cases the cause is unknown.
Bacterial causes of villitis include the following:
- Bacteria associated with maternal sepsis
Viral causes of villitis include:
- Cytomegalovirus (CMV)
Additionally, the following conditions are risk factors for villitis:
- Obesity during pregnancy
- Multiple pregnancy (pregnant with more than one baby)
- Urinary complications during pregnancy
Signs and Symptoms of Villitis
The signs and symptoms of chronic villitis include:
- Elevated levels of alpha-fetoprotein when intrauterine growth restriction (IUGR) is present
- Non-significant elevations of human growth hormone when testing biological screening of trisomy (abnormal number of chromosomes) in the second quarter
The signs and symptoms of acute villitis include:
- Abscesses in the placental parenchyma (villi)
- Neutrophilic chorioamnionitis
Villitis is usually not apparent (without a microscope) unless there is abscess formation. Abscesses can typically be seen with an ultrasound.
Villitis is associated with placental infections and therefore should be considered when any of the following conditions are present: CMV, chorioamnionitis, candida, HSV, group B streptococcus, group A streptococcus, syphilis, toxoplasmosis and chlamydia. It is crucial that physicians promptly diagnose and treat these infections because when villitis develops, there may be an increased risk for fetal death.
Treatment and Prevention of Villitis
Research has shown that when villitis is suspected, steroids and aspirin during pregnancy are beneficial. Most of the time, the cause of villitis is unknown. However, since villitis is associated with placental infections, it is imperative that these infections be immediately diagnosed and treated.
Outcomes of Villitis
If villitis is not properly prevented or promptly treated, it can lead to very serious outcomes in the baby, including:
- Hypoxic-ischemic encephalopathy
- Hydrops fetalis (abnormal amounts of fluid build-up in two or more body areas of a fetus or newborn)
- Intrauterine growth restriction (IUGR)
- Respiratory problems
- Cerebral palsy
- Periventricular leukomalacia
- Neonatal sepsis and meningitis
Villitis and Medical Malpractice
Some cases of villitis arise as the result of negligent actions by medical professionals. These may include:
- Failure to diagnose premature rupture of membranes (PROM), which is a major risk factor for chorioamnionitis and other infections
- Failure to follow standards of care in prevention of ascending infection
- Failure to diagnose and properly treat placental infections such as chorioamnionitis
- Failure to closely monitor the mother and baby when risk factors for chorioamnionitis and villitis are present
- Failure to obtain adequate informed consent. This includes advising the mother of the risks and alternatives of different delivery methods and procedures
- A lack of adherence to standard of care when delivering the baby
When negligence causes injury to the mother or baby, it is medical malpractice.
At Reiter & Walsh ABC Law Centers, we are dedicated to birth injury cases (which include infection and oxygen deprivation). Our award-winning attorneys understand the complex legal issues involved with pregnancy infection and will help you to obtain the compensation to which you are entitled. To begin your free case review, please contact Reiter & Walsh ABC Law Centers in any of the following ways:
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