MATERNAL PYREXIA DURING LABOR - NEONATAL STANDARD OF CARE

The risk of neonatal bacterial infection is ten times higher if the mother develops pyrexia during labor. However 75% of the neonates will not be infected and therefore antibiotics should not be systematically given. Additional risk factors of neonatal infection are suggested by the current obstetric history: premature labor, prolonged preterm premature rupture of the membranes, meconium stained amniotic fluid and fetal distress and have a better predictive value than late clinical evidence of infection or maternal biology. Direct examination of placental swabs and gastric fluid will confirm the likelyhood of infection and help choosing efficacious antibiotics. Systemic administration of at least two or three antibiotics to the neonate should include an aminoside and a betalactam and should cover the theoretical risk of resistant enterobacteria if infection develops after previous antibiotic therapy or during the hospital stay of the mother. Treatment will be maintained if microbiological examinations and neonatal biology clearly demonstrate an infection.