Postpartum endometritis: Difference between revisions
| Line 35: | Line 35: | ||
*Abx | *Abx | ||
**Outpatient | **Outpatient | ||
***Clindamycin 300mg PO TID | ***[[Clindamycin]] 300mg PO TID | ||
**Inpatient | **Inpatient | ||
***Clindamycin 900mg IV TID + gentamicin 1.5 mg/kg IV TID | ***[[Clindamycin]] 900mg IV TID + gentamicin 1.5 mg/kg IV TID | ||
==Disposition== | ==Disposition== | ||
Revision as of 06:11, 8 March 2014
Background
- Any postpartum woman with fever should be assumed to have a genital tract infection
Risk Factors
- Cesarean delivery (most important)
- Prolonged labor
- Prolonged ROM
- Internal fetal or uterine monitoring
- Large amount of meconium in amniotic fluid
- Manual removal of placenta
- Diabetes Mellitus
- Preterm birth
- Bacterial vaginosis
- Operative vaginal delivery
- Post-term pregnancy
- HIV infection
- Colonization with Group B Strep
Diagnosis
- Fever
- Foul-smelling lochia
- Leukocytosis
- Uterine tenderness
- Only scant discharge may be present (esp w/ group B strep)
DDX
- Respiratory tract infection
- UTI/urosepsis
- Pyelonephritis
- Intra-abdominal abscess
- Mastitis
- Thrombophlebitis
Treatment
- Abx
- Outpatient
- Clindamycin 300mg PO TID
- Inpatient
- Clindamycin 900mg IV TID + gentamicin 1.5 mg/kg IV TID
- Outpatient
Disposition
- Consult OB/GYN first if are considering outpt management
- Admit all pts who appear ill, have had a C-section, or underlying comorbid conditions
See Also
Source
- Tintinalli
- Rosen's