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Acad Pediatr. 2015 May-Jun;15(3):340-4. doi: 10.1016/j.acap.2014.11.007.

Management of newborns born to mothers with chorioamnionitis: is it time for a kinder, gentler approach?

Author information

1
Department of Pediatrics, University of Utah, Salt Lake City, UT.
2
Department of Pediatrics, University of Utah, Salt Lake City, UT. Electronic address: paul.young@hsc.utah.edu.

Abstract

OBJECTIVE:

Current recommendations are that newborns of mothers with chorioamnionitis have a complete blood count, blood culture, and antibiotic therapy. We hypothesized that utilizing the early-onset sepsis (EOS) risk calculator and a clinical symptom assessment could safely reduce the number of newborns subjected to laboratory testing and antibiotics.

METHODS:

We reviewed 698 well-appearing newborns of estimated gestational age of ≥34 weeks born to mothers with chorioamnionitis.

RESULTS:

Sixty-five percent of newborns were managed according to the guidelines; 1 (0.14%) had culture-positive EOS. A strategy based on the use of the EOS calculator and clinical appearance of the newborn would have reduced the proportion having laboratory tests and antibiotics to 12% and would not have missed any cases of EOS.

CONCLUSIONS:

The EOS risk in well-appearing newborns of mothers with chorioamnionitis is low. Applying a strategy based on readily obtainable measures rather than the obstetrical diagnosis of chorioamnionitis would result in a substantial reduction of newborns undergoing laboratory tests and being exposed to antibiotics. Further prospective trials evaluating the safety of this approach are warranted.

KEYWORDS:

chorioamnionitis; early-onset sepsis; newborns

PMID:
25906702
DOI:
10.1016/j.acap.2014.11.007
[Indexed for MEDLINE]

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