New Clinical Practice Guidelines, September 2017

John Anello; Brian Feinberg; Richard Lindsey; Cristina Wojdylo; Olivia Wong, DO; Yonah Korngold; John Heinegg. Sam Shlomo Spaeth

Disclosures

September 15, 2017

In This Article

Intra-amniotic Infection

Guidelines on intra-amniotic infection by the American College of Obstetricians and Gynecologists[11,12]

  • Intra-amniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death, as well as long-term infant complications such as bronchopulmonary dysplasia and cerebral palsy.

  • The diagnosis of suspected intra-amniotic infection is made when the maternal temperature is ≥39.0°C or when the maternal temperature is 38.0–38.9°C and one 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 intra-amniotic infection is suspected or confirmed. Antibiotics should be considered in the setting of isolated maternal fever unless a source other than intra-amniotic infection is identified and documented.

  • Intra-amniotic 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 intra-amniotic infection, or when other risk factors for early-onset neonatal sepsis are present in labor (eg, maternal fever, prolonged rupture of the membranes, or preterm birth), communication with the neonatal care team is essential to optimize neonatal evaluation and management.

For further reading, see Chorioamnionitis

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