Innovating Evaluation and Treatment of Intrapartum Fevers: Where Do We Go from Here?

Author:

Wilkie Gianna L.123,James Kaitlyn2,Ona Samsiya12,Easter Sarah Rae1,Chou Joseph4,Roberts Drucilla5,Sahin Zehra Ordulu5,Tuomala Ruth1,Diouf Khady1,Riley Laura26,Prabhu Malavika26

Affiliation:

1. Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

2. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

3. Department of Obstetrics and Gynecology, University of Massachusetts Medical School, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts

4. Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

5. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

6. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York City, New York

Abstract

As intrapartum fevers are not always infectious in origin, determining whether antibiotics are indicated is challenging. We previously sought to create a point-of-care calculator using clinical data available at the time of an intrapartum fever to identify the subset of women who require antibiotic treatment to avoid maternal and neonatal morbidity. Despite the use of a comprehensive dataset from our institutions, we were unable to propose a valid and highly predictive model. In this commentary, we discuss why our model failed, as well as future research directions to identify and treat true intraamniotic infection. Developing a risk-stratification model is paramount to minimizing maternal and neonatal exposure to unnecessary antibiotics while allowing for early identification of women and babies at risk for infectious morbidity. Key Points

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynaecology,Pediatrics, Perinatology, and Child Health

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