What are preventive measures in chorioamnionitis?

Updated: May 08, 2018
  • Author: Fayez M Bany-Mohammed, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Answer

Maternal antibiotic chemoprophylaxis is related to urogenital colonization with group B Streptococcus (GBS). Mothers are screened for GBS-related colonization at 35-37 weeks' gestation. Preterm labor before 35 weeks' gestation indicates that knowledge of GBS-related colonization of the urogenital tract is not immediately available.

The Centers for Disease Control and Prevention (CDC) continues to publish updated guidelines for prevention of perinatal GBS disease. [170, 171]  In 2011, the American Academy of Pediatrics (AAP) [227] and the American College of Obstetricians and Gynecologists (ACOG) [228]  released their recommendations regarding prevention of early-onset GBS disease in newborns on the basis of the 2010 CDC guidelines. The Society of Obstetricians and Gynaecologists of Canada (SOGC) published their recommendations for prevention of early-onset neonatal GBS disease in 2013. [229]

Table. Features of Isolated Maternal Fever and Triple I with Classification. [141] (Open Table in a new window)

Terminology Features and Comments
Isolated Maternal Fever 

 

(“Documented” fever)

Maternal oral temperature ≥39.0°C (≥102.2°F) on any one occasion is documented fever. If the oral temperature is between 38.0°C (100.4°F) and 39.0°C (102.2°F), repeat the measurement in 30 minutes; if the repeat value remains at least 38.0°C (≥100.4°F), it is documented fever.

Suspected Triple I

Fever without a clear source plus any of the following:

  • Baseline fetal tachycardia (>160 beats per min for 10 min or longer, excluding accelerations, decelerations, and periods of marked variability)
  • Maternal white blood cell count >15,000 per mm 3 in the absence of corticosteroids
  • Definite purulent fluid from the cervical os

Confirmed Triple I

All of the above plus:

  • Amniocentesis-proven infection through a positive Gram stain
  • Low glucose level or positive amniotic fluid culture
  • Placental pathology revealing diagnostic features of infection

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