Which finding most strongly suggests chorioamnionitis requiring urgent antibiotic therapy and delivery?

• A. Foul-smelling discharge with uterine tenderness.
• B. Fever alone.
• C. Fetal tachycardia as the only sign.
• D. Elevated blood pressure as the primary sign.

Answer: (B)

Fever during labor is the strongest signal that intra-amniotic infection (chorioamnionitis) may be present and requires urgent antibiotics and delivery. A maternal temperature of 38°C (100.4°F) or higher reflects a systemic response to infection in the amniotic cavity, indicating the infection could be affecting both mother and fetus. Because this systemic sign signals an active infectious process, prompt IV broad-spectrum antibiotics and expedited delivery are commonly needed to prevent maternal sepsis and fetal compromise.

Foul-smelling discharge with uterine tenderness can accompany chorioamnionitis and supports the concern, but fever alone already flags a systemic infection needing urgent management. Fetal tachycardia as the only sign is worrisome but less definitive on its own, and elevated blood pressure is not a typical marker of chorioamnionitis.