Document Detail


Choriophobia: a 1-act play.
MedLine Citation:
PMID:  22778303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of a newborn born to a mother with chorioamnionitis is controversial. By using data collected on neonates born in the era of routine maternal screening for Group B Streptococcus, we calculate that the risk of early-onset sepsis in a hypothetical infant born at term to a mother with chorioamnionitis, who has a normal physical examination at birth, is likely substantially <1% if the mother's screen for Group B Streptococcus was negative. This low rate of sepsis calls into question current guidelines recommending treatment of all such newborns with intravenous antibiotics for 48 hours pending the results of a blood culture. Current guidelines for the management of infants born to mothers with chorioamnionitis also raise an important ethical issue; the recommendation to treat these infants with intravenous antibiotics is, in essence, a de facto determination of what constitutes unacceptable risk to the newborn. We argue that this determination is ultimately value-based and therefore requires broader deliberation than that which frequently occurs among medical experts who develop medical guidelines.
Authors:
James A Taylor; Douglas J Opel
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Publication Detail:
Type:  Journal Article     Date:  2012-07-09
Journal Detail:
Title:  Pediatrics     Volume:  130     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-02     Completed Date:  2012-10-11     Revised Date:  2013-05-01    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Washington, Box 354920, Seattle, WA 98195-4920, USA. uncjat@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers
Adult
Anti-Bacterial Agents / therapeutic use
Chorioamnionitis / diagnosis*,  drug therapy*
Cooperative Behavior
Ethics, Medical
Female
Guideline Adherence / ethics
Humans
Infant, Newborn
Infusions, Intravenous / ethics
Interdisciplinary Communication
Internship and Residency
Medical Staff, Hospital
Pregnancy
Sepsis / diagnosis,  drug therapy
Streptococcal Infections / diagnosis*,  drug therapy*
Streptococcus agalactiae*
Unnecessary Procedures / ethics
Grant Support
ID/Acronym/Agency:
K23 HD069467/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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