Safety of spinal and epidural anesthesia in parturients with chorioamnionitis.
OBJECTIVE
The safety of spinal and epidural anesthesia in patients with chorioamnionitis was explored.


METHODS
A retrospective study was made of the charts of 517 parturients who had received epidural anesthesia and 14 who had received spinal anesthesia before delivery and whose placentas had subsequently been found to be positive for chorioamnionitis.


RESULTS
Of the 146 blood culture results that were reported, 13 were positive. Of these 13 blood cultures, 5 had been drawn within 6 hours after placement of the epidural block, and four of the five bacteremic patients did not receive antibiotics until after the regional anesthetic was administered. One quarter (11/45) of the patients who were febrile and three quarters (174/229) of those who had leukocytosis before their block received no antibiotics before the block was placed. After the epidural block was performed, the catheter was left in place for over 24 hours in 18% (46/260) of the women who spiked a fever and in 14% (18/130) of those who exhibited leukocytosis during that period. There was no report of an epidural or spinal abscess or of meningitis in any of the women in the study.


CONCLUSIONS
Conduction anesthesia may be safe in parturients with chorioamnionitis without prior antibiotic therapy.
Department of Anesthesiology, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
E J
EJ
Goodman
E
E
DeHorta
J M
JM
Taguiam
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002821:Chorioamnionitis; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D012189:Retrospective Studies