Intra-Amniotic Infection Flashcards
Premature rupture of membranes versus preterm premature rupture of membranes?
Rupture of membranes prior to the onset of labor versus before labor and gestation <37 weeks
Best management for chorioamnionitis? Etiology?
IV antibiotics (ampicillin, gentamicin, and third-generation cephalosporin, or clindamycin) and induction of labor
Ascending infection from vaginal organisms (GPS and gram-negative enterics)
How common is preterm premature rupture of membranes? Risk factors?
1%
- Bacterial – STI’s
- Uterus – multiple gestations, placental abruption
- Cervix – emergency cerclage, cervical conization
- Hydramnios
- External factors – cigarette smoking, lower socioeconomic status
How rule out preterm premature rupture of membranes?
- Pooling in posterior vaginal vault
- Alkaline changes of vaginal fluid (nitrozolieum)
- Ferning pattern
Outcome for PPROM?
Half of patients go into labor within 48 hours; 90% within one week
Chorioamnionitis affects how many pregnancies?
1% of all pregnancies; 7 to 10% of those with PPROM
Early signs of chorioamnionitis?
Fetal tachycardia (Heart rate >160)
Other findings in chorioamnionitis?
Maternal fever, maternal tachycardia, uterine tenderness, malodorous vaginal discharge
Most common precursor of neonatal sepsis? Maternal sequelae?
Chorioamnionitis; Endometritis and septic shock
Gold standard for diagnosis of chorioamnionitis?
Culture of the amniotic fluid yet amniocentesis (also good glucose, WBC count, protein, Gram stain)
Most sensitive screening test for chorioamnionitis?
IL-6
Chorioamnionitis typically complicates pregnancy by causing?
Exception? (Spread? Treatment?)
Premature rupture of membranes
Listeria; hematogenous spread; AVOID delivery and IV ampicillin
