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9 Cards in this Set
- Front
- Back
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Name 6 signs of maternal chorioamnionitis. |
1. Intrapartum fever (>100.4): most common finding 2. Significant maternal tachycardia (>120/min) 3. Fetal tachycardia (>160-180) 4. Purulent or foul smelling amniotic fluid or vaginal discharge 5. Uterine tenderness 6. Leucocytosis in mom (>15-18,000)--especially if a series of CBC's shows an upward trend |
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1. How many of the signs of chorioamnionitis should be present to greatly increase the risk of early newborn sepsis?
2. If there is a smaller number of signs than the answer above, how concerned about neonatal sepsis should we be? |
1. Two or more
2. We must be vigilant even if there are none! "Silent" chorioamnionitis is very real and frequent enough to be a problem. Also, the signs can be unrecorded in the mother's chart, and too many subjective factors are present. |
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If we suspect there might have been chorioamnionitis in the mother and the evidence remains ambiguous for it, what is the first thing we should do to clear the air? |
Ask the obstetrician directly for his or her opinion. |
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Name 3 effects of chorioamnionitis, be it silent or otherwise, upon the labor and delivery process itself. |
1. Initiate uteroplacental bleeding
2. Placental abruption
3. Uterine atony to the extent that oxytocin or even c/s are required |
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What 8 findings might be found on the physical exam of a mother afflicted by chorioamnionitis? |
1. An ill, toxic-looking appearance 2. Fever 3. Heart rate over 120 4. Hypotension 5. Diaphoresis 6. Cool, clammy skin 7. Abnormal looking or foul uterine or vaginal discharge 8. NOTHING AT ALL |
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Name 3 ultrasound findings that might or might not be present in the presence of chorioamnionitis. |
1. A biophysical profile of the fetus may reveal a lower than normal score.
2. Lack of fetal "breathing"
3. "Sludge" either settling at the amniotic fluid-cervical interface or hyperechogenic free-floating globs (But this can be seen in a symptomatic women as well) |
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Name 4 clinical events often associated with chorioamnionitis and/or early newborn sepsis. |
1. History of premature birth 2. Premature labor 3. Premature rupture of membranes before labor has begun 4. Prolonged rupture of membranes |
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What obstetric procedure in the perinatal period can cause fever in mother and/or neonate? |
Epidural anesthesia |
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Following an epidural, what 3 observations made upon a newborn with fever can ease our minds about the presence of sepsis? |
1. The newborn must act normally and not look sick 2. The APGARs are normal 3. The fever should dissipate quickly over the next 30-60' |
