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Intrapartum Management of Intraamniotic Infection

Obstet Gynecol; 2017 Aug; Comm on Obstet Prac

Recognition of intrapartum intraamniotic infection and implementation of treatment recommendations are essential steps that can minimize morbidity and mortality for women and newborns. This according to a new Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) on intrapartum management of intraamniotic infection, also referred to as chorioamnionitis. Among the ACOG recommendations:

  • The diagnosis of suspected intraamniotic infection is made when the maternal temperature is greater than or equal to 39.0°C or when the maternal temperature is 38.0–38.9°C and 1 additional clinical risk factor is present.
  • Isolated maternal fever is defined as any maternal temperature between 38.0°C and 38.9°C with no additional risk factors present, and with or without persistent temperature elevation.
  • Administration of intrapartum antibiotics is recommended whenever an intraamniotic infection is suspected or confirmed. Antibiotics should be considered in the setting of isolated maternal fever unless a source other than intraamniotic infection is identified and documented.
  • Intraamniotic infection alone is rarely, if ever, an indication for cesarean delivery.
  • Regardless of institutional protocol, when obstetrician–gynecologists or other obstetric care providers diagnose an intraamniotic infection, or when other risk factors for early-onset neonatal sepsis are present in labor, communication with the neonatal care team is essential to optimize neonatal evaluation and management.

Citation:

Intrapartum management of intraamniotic infection. Committee Opinion No. 712. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e95–101. doi:10.1097/AOG.0000000000002236.