UW + mehl CHORIOAMNIONITIS 02-20 (1)

Question 1

UW table. risk factors?6

Answer 1

prolonged rupture of membrane >18h
PPROM
Prolonged labor
Internal fetal/uterine monitoring devices
repetitive vaginal examinations

Question 2

UW table. Dx criteria?

Answer 2

MATERNAL FEVER + at least one or more:
fetal tachy > 160
maternal leukocytosis
purulent amniotic fluid

Question 3

UW table. Mx? 2

Answer 3

Broad spectrum abs (polymicrobial infection)
Delivery

Question 4

UW table. complications - maternal? 2

Answer 4

postpartum hemorrhage, endometritis

Question 5

UW table. complications - fetal? 3

Answer 5

preterm birth, pneumonia, encephalopathy

Question 7

UW. Infection occurs due to exposure of the uterine cavity contents (eg, fetus, placenta) with ascending vaginal and enteric pathogens.

Answer 7

Patients with intraamniotic infection present with fever, sustained fetal tachycardia >160/min, maternal leukocytosis, and/or purulent amniotic fluid.

other clinical: maternal tachycardia and uterine fundal tenderness

Question 8

UW. when delivery indicated?

Answer 8

When patients exhibit signs of overt infection, the risks of infection complications outweigh the risks of prematurity, and delivery is indicated regardless of gestational age.

Question 9

UW. oligohydramnios is not indication for delivery in PPROM + infection, because it occurs BECAUSE of PPROM.
indication is CP signs, eg fetal tachy.

Answer 9

.

Question 10

UW. chorio + PPROM Mx buvo prie PPROM dalies algoritmo.

Answer 10

<34 weeks gestation is typically expectant.
despite gestational age: overt signs of intraamniotic infection (eg, fever, fetal tachycardia), delivery is indicated to decrease maternal and neonatal morbidity

Question 11

UW. what bacterial infection?

Answer 11

polymicrobial

Question 12

Uw. because its polymycrobal, what Mx? 2

Answer 12

broad-spectrum intravenous antibiotics (eg, ampicillin, gentamicin, clindamycin)
and
immediate delivery via augmentation of labor (to remove the source of infection).

Question 13

UW. buvo case kur augmentation vs s/c.
when need sc?

Answer 13

Cesarean delivery is reserved for standard obstetric indications (eg, nonreassuring fetal tracing, breech presentation, prior uterine surgeries). Although this heart rate tracing indicates fetal tachycardia, it is reassuring overall due to moderate variability and no decelerations.

Question 14

UW. what drugs contraindicated?

Answer 14

Tocolytics (eg, nifedipine, indomethacin)

Question 15

UW. why patients cannot be managed expectantly?

Answer 15

the risks of maternal and fetal complications of infection outweigh the risks of prematurity.

Question 16

UW. common causes of fetal tachy?

Answer 16

Common causes of fetal tachycardia include maternal infection, poorly controlled maternal hyperthyroidism, medication use (eg, terbutaline), and abruptio placentae

Question 17

UW. in general, what patients do not meet ,,expectant Mx”?

Answer 17

patients who develop complications (eg, placental abruption, cord prolapse) do not meet criteria for expectant management

Question 18

UW. intraamniotic infection (IAI) (ie, chorioamnionitis), a fulminant polymicrobial infection of the amniotic sac, fetus, cord, and placenta from ascending vaginal flora

Answer 18

Mx therapeutic antibiotics and immediate delivery (eg, induction of labor), regardless of gestational age.

Question 19

Mehl. tik pora sakiniu buvo.
- Infection of the uterus during pregnancy.
- Greatest risk factor is ROM >18 hours.
- Cause is usually polymicrobial.

What is Tx? abs kombinacija

Answer 19

Tx = ampicillin + gentamicin +/- clindamycin.