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.
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.
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