Professor Fergal Malone:

I completely agree with Dr. Mahony that when the clinical signs of chorioamnionitis are present, it is a very easy diagnosis to make. The HSE guideline, as the Senator quoted accurately, is to get on with providing care and carry on with a pregnancy termination. The point is that sub-clinical chorioamnionitis is a real issue. Patients often do not show they have a temperature or tachychardia, fast heart rate, foul-smelling fluid or a tender abdomen until much later in the course. If a patient has ruptured membranes for 14, 15 or 16 weeks, she could well be developing it. She has virtually no prospect of getting to a gestational age at which she will have a live baby, yet brewing inside her, without showing any sign of clinical infection, there can be a serious infection. It is a real issue.