Triple I Framework (Intraamniotic Infection)

What the result means

Isolated maternal fever

One reading of 39.0 C or more, OR two of 38.0 to 38.9 C at least 30 minutes apart, with no clear alternative source. A category in its own right.

Not an infection

That first category is NOT a diagnosis of infection. Separating fever from Triple I was the point of the framework.

Why it mattered

Fever alone used to be labelled chorioamnionitis, which committed the mother to antibiotics and the newborn to a sepsis evaluation.

Suspected Triple I

Fever plus ONE of: fetal tachycardia above 160 bpm; a white cell count above 15,000 per mm3 without recent corticosteroids; purulent fluid from the cervical os.

Confirmed Triple I

Suspected plus ONE of: a positive amniotic fluid Gram stain; low amniotic glucose or a positive culture; histologic evidence of infection in the placenta.

A single 38.5

Satisfies NEITHER route. One reading counts only at 39.0 or above; below that it takes two, at least 30 minutes apart.

Steroids void the count

The leukocytosis criterion requires the absence of recent corticosteroids, since betamethasone raises the count itself - and antenatal steroids are common in this group.