Treatment of Chorioamnionitis with Piperacillin/Tazobactam and Clindamycin

Main Article Content

Metin Kaba

Abstract

Objective: Chorioamnionitis is a condition that bacteria infects the chorion and amnion and the amniotic fluid which can affect pregnant women. Infections may affect both the mother and fetus. Cervical insufficiency and chorioamnionitis cause preterm birth and perinatal morbidities.


Case: A 37-year-old patient was referred to the clinic with the diagnosis of preterm labor and cervical insufficiency at 26 weeks + 4 days of pregnancy. Cervix was 3 cm dilated, effaced 70%, the amnion membrane intact, and there was a cerclage thread on the cervix. There was a single, viable fetus in the uterine cavity with fetal measurements compatible with 27-28 weeks on ultrasonography. Ampicillin and azithromycin treatments were started. On the seventh day of observation, leukocytes and C reactive protein values had increased, and there was an onset of serohemorrhagic vaginal discharge. Thereupon, intravenous treatment of piperacillin/tazobactam and clindamycin started. Signs of chorioamnionitis were resolved. The patient was delivered on day 38 of admission due to vaginal bleeding. The newborn and patient outcomes were good. Further studies are needed to evaluate the new treatment regime's efficacy in chorioamnionitis treatment.

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How to Cite
Kaba, M. (2022). Treatment of Chorioamnionitis with Piperacillin/Tazobactam and Clindamycin. Medical Science and Discovery, 9(6), 368–370. https://doi.org/10.36472/msd.v9i6.740
Section
Case Reports
Received 2022-05-02
Accepted 2022-06-08
Published 2022-06-29

References

Roman A, Suhag A, Berghella V. Overview of Cervical Insufficiency: Diagnosis, Etiologies, and Risk Factors. Clin Obstet Gynecol. 2016;59(2):237-40. DOI: https://doi.org/10.1097/GRF.0000000000000184

Wafi A, Faron G, Parra J, Gucciardo L. Influence of cervical cerclage interventions upon the incidence of neonatal death: a retrospective study comparing prophylactic versus rescue cerclages. Facts Views Vis Obgyn. 2018;10(1):29-36.

Hansen LK, Becher N, Bastholm S, Glavind J, Ramsing M, Kim CJ, et al. The cervical mucus plug inhibits, but does not block, the passage of ascending bacteria from the vagina during pregnancy. Acta Obstet Gynecol Scand. 2014; 93(1):102–8. DOI: https://doi.org/10.1111/aogs.12296

Vornhagen J, Quach P, Santana-Ufret V, Alishetti V, Brokaw A, Armistead B, et al. Human Cervical Mucus Plugs Exhibit Insufficiencies in Antimicrobial Activity Towards Group B Streptococcus. J Infect Dis. 2018;217(10):1626-36. DOI: https://doi.org/10.1093/infdis/jiy076

Pang Q, Jia X, Chen L. Perinatal Outcomes After Emergency Cervical Cerclage for Cervical Insufficiency with Prolapsed Membranes. Med Sci Monit. 2019;25:4202–4206. DOI: https://doi.org/10.12659/MSM.916480

Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213(4 Suppl):S29-52. DOI: https://doi.org/10.1016/j.ajog.2015.08.040

Brown RG, Chan D, Terzidou V, Lee YS, Smith A, Marchesi JR, MacIntyre DA, Bennett PR. Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage. BJOG. 2019;126(7):916-925. DOI: https://doi.org/10.1111/1471-0528.15600

Mönckeberg M, Valdés R, Kusanovic JP, Schepeler M, Nien JK, Pertossi E, et al. Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis. J Perinat Med. 2019;47(5):500-509. DOI: https://doi.org/10.1515/jpm-2018-0388

Oh KJ, Romero R, Park JY, Lee J, Conde-Agudelo A, Hong JS, Yoon BH. Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency. Am J Obstet Gynecol. 2019;221(2):140.e1-140.e18. DOI: https://doi.org/10.1016/j.ajog.2019.03.017

Gravett MG, Adams KM, Sadowsky DW, Grosvenor AR, Witkin SS, Axthelm MK, Novy MJ. Immunomodulators plus antibiotics delay preterm delivery after experimental intraamniotic infection in a

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