Chorioamnionitis

Clinical Description

Intra-uterine infection in pregnancy.

Signs and Symptoms

• Foul-smelling vaginal discharge after 28 weeks of pregnancy, Fever/chills, abdominal pain, uterine tenderness, maternal and fetal tachycardia, maternal tachypnoeic.

Pharmacological

At the Health Centre

• Give Benzylpenicillin 2.5 MU IV stat or
• Give Ampicillin 2gms IV stat

Refer to hospital

At hospital

• Give Metronidazole 500mg IV 8 hourly, and Ampicillin 1g 6 hourly /Benzylpenicillin 2 MU IV 6 hourly, Gentamycin 240 mg IM single dose daily.
• Deliver urgently, Induce, or accelerate labor with Oxytocin if the cervix is favorable and no contraindications; do caesarean section if necessary.
• If mother has amnionitis or if membranes were ruptured for more than 12 hours before delivery, start newborn on Benzylpenicillin 50,000 IU/kg/dose IM 12 hourly, and Gentamycin 5 mg/kg IM od for 5 days if birth weight >1500 g).
• Continue for 48 hours after the fever subsides, but not less than 5 days.