Successful outcome after antibiotic treatment of postamniocentesis membrane rupture and chorioamnionitis in multiple pregnancy.
Postamniocentesis chorioamnionitis is usually managed with induction of labor to prevent maternal sepsis and related morbidity and mortality. We report a case of chorioamnionitis in a triplet pregnancy after midtrimester genetic amniocentesis, in which multiple antibiotic treatment (ampicillin 2 g i.v. loading dose followed by 1 g i.v. every 6 hr; clindamycin 900 mg i.v. every 8 hr; gentamicin 120 mg i.v. loading dose followed by 100 mg i.v. every 8 hrs; and erythromycin 500 mg i.v. every 6 hr) for 7 days and delivery of the presumably infected triplet A successfully reversed the clinical symptomatology, allowing prolongation of pregnancy until 26 weeks and survival of the remaining fetuses. At age 2 years, both infants are doing well and are meeting their developmental milestones. The viable outcome of this management strategy suggests that antibiotic treatment and expectancy may be an option in selected cases of postamniocentesis chorioamnionitis in multiple pregnancies.
Ghidini
A
A
Perinatal Diagnostic Center, Inova Alexandria Hospital, Virginia 22304, USA.
Doria
V
V
Kirn
V
V
Korker
V
V
D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D000667:Ampicillin / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D002821:Chorioamnionitis / Q000188:drug therapy* / Q000209:etiology; D002981:Clindamycin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004917:Erythromycin / Q000008:administration & dosage; D005260:Female; D005313:Fetal Death; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy / Q000209:etiology; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D016104:Oligohydramnios / Q000188:drug therapy / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D014310:Triplets
D000893:Anti-Inflammatory Agents; D005839:Gentamicins; D002981:Clindamycin; D004917:Erythromycin; D000667:Ampicillin; D001623:Betamethasone