Chorioamnionitis - Revision history

Rossdonaldson1: /* Disposition */

2022-06-07T21:37:41Z

Disposition

← Older revision		Revision as of 21:37, 7 June 2022
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	==Disposition==		==Disposition==
	*Admit~~<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>~~		*Admit
	**Due to concern for [[neonatal sepsis]]; patients should be given for IV [[antibiotics]], supportive care, and possible early [[delivery]]		**Due to concern for [[neonatal sepsis]]; patients should be given for IV [[antibiotics]], supportive care, and possible early [[delivery]]<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>

	==Complications==		==Complications==

Rossdonaldson1: /* Disposition */

2022-06-07T21:37:22Z

Disposition

← Older revision		Revision as of 21:37, 7 June 2022
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	==Disposition==		==Disposition==
	*~~Given~~ concern for [[neonatal sepsis]], patients should be ~~admitted~~ for IV [[antibiotics]], supportive care, and possible early [[delivery]]~~<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>~~		*Admit<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>
			**Due to concern for [[neonatal sepsis]]; patients should be given for IV [[antibiotics]], supportive care, and possible early [[delivery]]

	==Complications==		==Complications==

Rossdonaldson1: /* Disposition */

2022-06-07T21:36:25Z

Disposition

← Older revision		Revision as of 21:36, 7 June 2022
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	==Disposition==		==Disposition==
	Given concern for neonatal sepsis, patients should be admitted for IV antibiotics, supportive care, and possible early delivery<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>		*Given concern for [[neonatal sepsis]], patients should be admitted for IV [[antibiotics]], supportive care, and possible early [[delivery]]<ref>Driscoll SG. Chorioamnionitis: perinatal morbidity and mortality. Pediatr Infect Dis. 1986;5</ref>

	==Complications==		==Complications==

Rossdonaldson1: /* Workup */

2022-06-07T21:27:30Z

Workup

← Older revision		Revision as of 21:27, 7 June 2022
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	*Extra-amniotic infections such as [[pyelonephritis]], [[appendicitis]], [[pneumonia]]		*Extra-amniotic infections such as [[pyelonephritis]], [[appendicitis]], [[pneumonia]]

	==Workup==		==Evaluation==
			===Workup===
	*CBC		*CBC
	*[[Blood cultures]]		*[[Blood cultures]]

Cdichang: /* Management */

2020-11-29T20:04:15Z

Management

← Older revision		Revision as of 20:04, 29 November 2020
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	==Management==		==Management==
	*[[Ampicillin]] IV 2g Q6H AND [[Gentamicin]] IV 5mg/kg once daily <ref>Snyder M. et al. Clinical inquiries. What treatment approach to intrapartum maternal fever has the best fetal outcomes?. J Fam Pract. May 2007;56(5):401-2</ref> <ref>Lyell DJ, Pullen K, Fuh K, Zamah AM, Caughey AB, Benitz W, El-Sayed YY. Daily compared with 8-hour gentamicin for the treatment of intrapartum chorioamnionitis: a randomized controlled trial. Obstet Gynecol. 2010 Feb;115(2 Pt 1):344-9</ref>		*[[Ampicillin]] IV 2g Q6H AND [[Gentamicin]] IV 5mg/kg once daily (adjust based on renal function) <ref>Snyder M. et al. Clinical inquiries. What treatment approach to intrapartum maternal fever has the best fetal outcomes?. J Fam Pract. May 2007;56(5):401-2</ref> <ref>Lyell DJ, Pullen K, Fuh K, Zamah AM, Caughey AB, Benitz W, El-Sayed YY. Daily compared with 8-hour gentamicin for the treatment of intrapartum chorioamnionitis: a randomized controlled trial. Obstet Gynecol. 2010 Feb;115(2 Pt 1):344-9</ref>
	*Alternative antibiotic regimens:		*Alternative antibiotic regimens:
	**[[Ampicillin-sulbactam]] IV 2g Q6H		**[[Ampicillin-sulbactam]] IV 2g Q6H

Cdichang: /* Management */

2020-11-29T20:03:45Z

Management

← Older revision		Revision as of 20:03, 29 November 2020
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	==Management==		==Management==
	*[[Ampicillin]] IV 2g Q6H AND [[Gentamicin]] IV 1.5mg/kg ~~Q8H~~<ref>Snyder M. et al. Clinical inquiries. What treatment approach to intrapartum maternal fever has the best fetal outcomes?. J Fam Pract. May 2007;56(5):401-2</ref>		*[[Ampicillin]] IV 2g Q6H AND [[Gentamicin]] IV 5mg/kg once daily <ref>Snyder M. et al. Clinical inquiries. What treatment approach to intrapartum maternal fever has the best fetal outcomes?. J Fam Pract. May 2007;56(5):401-2</ref> <ref>Lyell DJ, Pullen K, Fuh K, Zamah AM, Caughey AB, Benitz W, El-Sayed YY. Daily compared with 8-hour gentamicin for the treatment of intrapartum chorioamnionitis: a randomized controlled trial. Obstet Gynecol. 2010 Feb;115(2 Pt 1):344-9</ref>
	*Alternative antibiotic regimens:		*Alternative antibiotic regimens:
	**[[Ampicillin-sulbactam]] IV 2g Q6H		**[[Ampicillin-sulbactam]] IV 2g Q6H

Cdichang: /* Signs and Symptoms */

2020-11-29T19:45:39Z

Signs and Symptoms

← Older revision		Revision as of 19:45, 29 November 2020
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	==Clinical Features==		==Clinical Features==
	===Signs and Symptoms===		===Signs and Symptoms===
	*Maternal [[fever]] (intra-partum temperature 102.2°F (≥39.0°C) once, OR two temperatures between >100.4°F - 102.2°F measured 30 min apart) with no other clear infectious source <ref>Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426</ref>		*Maternal [[fever]] (intra-partum temperature 102.2°F (≥39.0°C) once, OR two temperatures between >100.4°F - 102.2°F measured 30 min apart) with no other clear infectious source <ref>Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426</ref> PLUS
	*One or more of the following		*One or more of the following
	**Fetal tachycardia (>160-180 beats/min)		**Fetal tachycardia (>160-180 beats/min)

Cdichang: /* Signs and Symptoms */

2020-11-29T19:45:14Z

Signs and Symptoms

← Older revision		Revision as of 19:45, 29 November 2020
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	**Maternal [[leukocytosis]] (total blood leukocyte count >15,000/mm3)		**Maternal [[leukocytosis]] (total blood leukocyte count >15,000/mm3)

	Maternal tachycardia and uterine tenderness, suggestive but not specific.		*Maternal tachycardia and uterine tenderness, suggestive but not specific.

	===Presentation===		===Presentation===

Cdichang: /* Signs and Symptoms */

2020-11-29T19:44:53Z

Signs and Symptoms

← Older revision		Revision as of 19:44, 29 November 2020
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	==Clinical Features==		==Clinical Features==
	===Signs and Symptoms===		===Signs and Symptoms===
	*Maternal [[fever]] (intra-partum temperature 102.2°F (≥39.0°C)once, OR two temperatures between >100.4°F - 102.2°F measured 30 min apart) with no other source <ref>Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426</ref>		*Maternal [[fever]] (intra-partum temperature 102.2°F (≥39.0°C) once, OR two temperatures between >100.4°F - 102.2°F measured 30 min apart) with no other clear infectious source <ref>Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426</ref>
	*One or more of the following		*One or more of the following
	**Fetal tachycardia (>160-180 beats/min)		**Fetal tachycardia (>160-180 beats/min)

Cdichang: /* Signs and Symptoms */

2020-11-29T19:44:21Z

Signs and Symptoms

← Older revision		Revision as of 19:44, 29 November 2020
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	==Clinical Features==		==Clinical Features==
	===Signs and Symptoms===		===Signs and Symptoms===
	*Maternal [[fever]] (intra-partum temperature >100.~~4 °F or >37~~.~~8 °C~~)<ref>~~Apantaku O~~, ~~Mulik V~~. ~~Maternal intra-partum fever~~. J Obstet ~~Gynaecol. 2007 Jan~~; ~~27(1)~~:~~12-5.~~</ref>		*Maternal [[fever]] (intra-partum temperature 102.2°F (≥39.0°C)once, OR two temperatures between >100.4°F - 102.2°F measured 30 min apart) with no other source <ref>Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop. Obstet Gynecol 2016; 127:426</ref>
	*~~Significant maternal tachycardia (>120 beats/min)~~		*One or more of the following
	*Fetal tachycardia (>160-180 beats/min)		**Fetal tachycardia (>160-180 beats/min)
	*Purulent or foul-smelling amniotic fluid or [[vaginal discharge]]		**Purulent or foul-smelling amniotic fluid or [[vaginal discharge]]
	*~~Uterine tenderness~~		**Maternal [[leukocytosis]] (total blood leukocyte count >15,000/mm3)
	*Maternal [[leukocytosis]] (total blood leukocyte count >15,000~~-18,000 cell~~/µL)
			Maternal tachycardia and uterine tenderness, suggestive but not specific.

	===Presentation===		===Presentation===