| Choriophobia: a 1-act play. | |
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MedLine Citation:
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PMID: 22778303 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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James A Taylor; Douglas J Opel |
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Publication Detail:
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Type: Journal Article Date: 2012-07-09 |
Journal Detail:
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Title: Pediatrics Volume: 130 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-08-02 Completed Date: 2012-10-11 Revised Date: 2013-05-01 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 342-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, University of Washington, Box 354920, Seattle, WA 98195-4920, USA. uncjat@u.washington.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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K23 HD069467/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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