Maternal Sepsis Flashcards
what can untreated maternal sepsis lead to?
septic shock
death
what is the management for suspected sepsis?
ABCDE
sepsis 6
what antibiotics should be given in the first hour if maternal sepsis is suspected?
IV co-amoxiclav
+/- gentamicin
+/- clindamycin if the patient has a sore throat
what antibiotics should be given in the first hour if maternal sepsis is suspected in a penicillin allergic patient?
clindamycin + gentamici
what antibiotics should be given for maternal septic shock?
tazocin, clindamycin and gentamicin
what is chorioamnionitis?
inflammation of the amniochorionic membranes of the placenta
what increases the risk of chorioamnionitis?
PROM
invasive pre-natal diagnostics
prolonged labour
nulliparity
what usually causes chorioamnionitis?
ascending infection
how does chorioamnionitis present?
offensive PV loss
foetal CTG concerns
maternal pyrexia
abdominal pain
what is the possible complications if chorioamnionitis is not treated?
neonatal sepsis
how is chorioamnionitis managed?
broad spectrum IV antibiotics
how should delivery be approached in chorioamnionitis?
not in established labour = IOL or LUSCS
what mode of contraception should be avoided following chorioamnionitis?
post partum intrauterine contraception
what increases the risk of neonatal problems due to group B strep?
pre term labour
PROM
what neonatal complications can be caused by group B strep?
neonatal sepsis
pneumonia
meningitis
what intrapartum prophylaxis can be given for group B strep infection?
benzylpenicillin or clindamycin
when would intrapartum prophylaxis be given for group B strep infection?
GBS detected antenatally
previous baby affected
delivery <37 weeks
what is endometritis?
infection of the uterine lining
what are some risk factors for endometritis in the postpartum period?
operative delivery
prolonged labour
retained products of conception (RPOC)
how does endometritis present?
abdominal pain
abnormal PV bleeding
offensive PV loss
how is endometritis managed?
co-amoxiclav
(co-trimoxazole + metronidazole if pen allergic)
may need surgical evacuation of the uterus for RPOC
how does mastitis present?
unilateral, painful, inflamed breast in breastfeeding mothers
what is the first line management of mastitis?
complete breast emptying by feeding/expressing
warm compresses
NSAIDs
what management is done for mastitis that is not improving or has signs of sepsis?
flucloxacillin
clindamycin if pen allergic
what should be suspected if mastitis doesnt respond to antibiotics?
breast abscess
also if there is fluctuant swelling
how is a breast abscess managed?
refer to breast team for ultrasound and drainage
how can an epidural abscess present?
back pain
fever
what are the possible complications of epidural abscess?
neurological deficits
how can epidural abscess be diagnosed?
MRI
how is epidural abscess managed?
IV antibiotics = vancomycin, metronidazole, cefotaxime
surgical decompression
