A First Look at Chorioamnionitis Management Practice Variation among US Obstetricians

Table 3

Diagnostic and treatment strategies.

Diagnostic strategies	𝑁=212
Diagnosis based on
Temperature alone	56 (26.4%)
Temperature plus one additional criterion	130 (61.3%)
Temperature plus two additional criteria	16 (7.6%)
Other	10 (4.7%)
Most common temperature threshold (degrees Centigrade)
37.9	6 (2.8%)
38.0	154 (73.0%)
38.1	23 (10.9%)
38.2	18 (8.5%)
Other	10 (4.7%)
Strategies used to lower temperature prior to diagnosis
None	65 (31.0%)
Intravenous fluids	124 (59.0%)
Acetaminophen	15 (7.1%)
Other	6 (2.9%)
Influenced by presence of epidural in making diagnosis
No	124 (58.8%)
More likely to diagnose	10 (4.7%)
Less likely to diagnose	77 (36.5%)
Neonatal sepsis workup required for all chorioamnionitis diagnoses
Yes	170 (83.3%)
No	34 (16.7%)
Influenced by neonatal sepsis workup policy in making diagnosis
No	191 (91.0%)
More likely to diagnose	5 (2.3%)
Less likely to diagnose	14 (6.7%)
Treatment Strategies	𝑁=212
Primary treatment regimen
Ampicillin and gentamicin ± additional agent	135 (65.2%)
Single agent	62 (30.0%)
Includes Gram-negative coverage	177 (85.5%)
Does not include Gram-negative coverage	30 (14.5%)
Change regimens for cesarean delivery
Yes	99 (46.9%)
No	112 (53.1%)
Postpartum treatment strategy after vaginal delivery
No additional antibiotics	73 (34.6%)
1 additional dose	20 (9.5%)
24 hours postpartum	56 (26.5%)
24 hours afebrile	3 (1.4%)
48 hours postpartum	52 (24.7%)
48 hours afebrile	4 (1.9%)
Other	3 (1.4%)
Postpartum treatment strategy after cesarean delivery
No additional antibiotics	24 (11.3%)
1 additional dose	15 (7.1%)
24 hours postpartum	70 (33.0%)
24 hours afebrile	17 (8.0%)
48 hours postpartum	68 (32.1%)
48 hours afebrile	16 (7.6%)
Other	2 (0.9%)
Treat with oral antibiotics after intravenous course completed
Yes	34 (16.2%)
No	176 (83.8%)