Sun Jan 07 2018

Intrapartum Differential diagnosis for Temp >38.0C Epidural fever (transient), DVT/PE (if prolonged IOL or limited mobility), UTI, Intraamniotic infection (with or without ROM), etc   Chorioamnionitis aka IAI aka Triple-I (intrapartum intraamniotic Infection) One temp >39.0C One temp 38.0C-39.0C AND one or more risk factors Two temps >38.0C 30+ mins apart Tx: the standard is Ampicillin/Gentamycin until delivery. Tylenol prn temp>38C, IVF for maternal/fetal tachycardia, cooling blanket if needed to decrease temp.   If mild PCN allergy: Ancef/Gent If severe PCN allergy: gent/clinda or gent/vanc   If vaginal delivery: No evidence that continued abx postpartum provide benefit.   If c-section: Add clindamycin to Amp/Gent. Continue at least 1 dose postpartum. Clinical judgment on when to d/c. Some do 1 dose, some 24hrs afebrile, until clinical improvement, etc.   Postpartum Wind – PNA, atelectasis, URI Womb – Endomyometritis — Gent/Clinda x 24hrs afebrile Wound – Superfici...