Intrapartum and Postpartum Management of Intra-amniotic Infection.

IMPORTANCE: Intra-amniotic infection (IAI) is a common condition with potentially devastating maternal and neonatal complications. However, there are incomplete data regarding the most effective antimicrobial treatment regimen for this condition. OBJECTIVE: This article aims to review the current evidence and recommendations for intrapartum and postpartum management of IAI. EVIDENCE ACQUISITION: Original research articles, review articles, and guidelines on IAI were reviewed. RESULTS: Numerous known risk factors for IAI exist, some of which are modifiable. Serious neonatal complications can result from exposure to IAI including increased risk of preterm birth and neonatal death. Possible maternal complications include increased risk of cesarean delivery, postpartum hemorrhage, and postpartum endometritis. Antibiotics are the mainstay of treatment for IAI for both mothers and neonates, although there is no consensus on which antimicrobial agents are best and the appropriate duration of therapy. CONCLUSIONS AND RELEVANCE: Monitoring patients for signs of IAI, proper treatment, and communication of the diagnosis with the pediatric team are essential for preventing maternal and neonatal complications of IAI. More research is needed to determine the proper treatment regimens for both mothers diagnosed with IAI and their neonates.

Duke Scholars

Author Jeffrey Adam Kuller Obstetrics and Gynecology, Maternal Fetal Medicine

Author Sarah K. Dotters-Katz Obstetrics and Gynecology, Maternal Fetal Medicine