Perspectives on Maternal Mortality and Morbidity – Treating Infection During Labor & Delivery (w/AD)


DR. ROBERTO ROMERO: Typically,
the most common infection in labor and delivery
units is called clinical chorioamnionitis. That condition is generally treated
with the administration of antibiotics. Recently, with the
use of epidural for the relief of pain, we
have realized that 10% to 20% of women develop a fever. And the fundamental question is, who has a fever due to
infection versus a fever related to epidural? We have now determined
that approximately 60% of all patients who develop
a fever in the labor and delivery unit have proven
intra-amniotic infection. That means that we are able
to identify a bacteria. These microorganisms
are not generally covered by the
standard antibiotics that we are using in
clinical medicine. And these microorganisms
can also infect the baby. The implications
of this is that we will need to revisit the
scheme of antibiotics that are administered
to women who have an infection during labor, in order
to treat effectively these infections. And also we will need to search for
these microorganisms in the neonates.

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