Re: AMOL
From: ainsron@msn.com
Wed Apr 10 00:39:24 2002
If you follow the CDC guidelines and choose to culture all, then GBS
negative patients should not be treated prophylactically just because
they cross a magic time line. You should treat them only if they show
signs of infection. If you follow the CDC guidelines and choose not
culture or if a patient is GBS unknown, then patients should be treated
by risk factors, such as: less than 37 wks, ROM >18 hours... or if
signs of infection, which is no longer prophylactic.
>I had this conversation with Carol Baker from Baylor, the "Group B. Strep"
>maven. She felt that since the usual hospital setting may take up to 1-2
>hours to start antibiotics after order is submitted, she recommends ordering
>them 12-14 hours after rupture of membranes. I was also under the impression
>that when a patient has been ruptured for 18 hours (18 hours after a
>cervical exam with rupture) antibiotics should be started to decrease the
>risk of chorioamnionitis.
>
>--
>Richard Chudacoff, MD, FACOG
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
>ainsron@sbcglobal.net
>Sent: Tuesday, April 09, 2002 7:52 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: AMOL
>
>I would only use antibiotics if GBS+ or treat if signs of infection.
>
>>No protocol, but I do like aggressive Pitocin and start antibiotics about
>>12-14 hours after ROM. I don't use 12 hours, too boilerplate. Primary
>>c-section rate is less than 7%, so I guess it works.
>>
>>--
>>Richard Chudacoff, MD, FACOG
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Bernard
>>Cristalli
>>Sent: Tuesday, April 09, 2002 3:46 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: AMOL
>>
>>So OK for AMOL with me, except the 12 hours dead-line.
>>
>>--
>>Bernard Cristalli MD AMACOG
>>AIHP - ACCA
>>Paris France
>>Bernard.Cristalli@CliniquedelEssonne.fr
>>http://www.CliniquedelEssonne.fr
>>http://www.obgyn.net/corresp/cristalli.htm
>>http://www.gyneweb.fr
>>'64 Mk2 3.8
>>
>>De : PELLIS45@aol.com
>>Répondre à : ob-gyn-l@obgyn.net
>>Date : Tue, 9 Apr 2002 15:35:08 -0500
>>À : Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
>>Objet : Re: AMOL
>>
>>In a message dated 4/9/02 4:23:14 PM Eastern Daylight Time,
>>bcrist@club-internet.fr writes:
>>
>>What do you mean by AMOL?
>>
>>......active management of labor. Strict adherence to the Friedman Curve,
>>pit for induction and augmentation, routine epidural, deliver in 12 hours
>>whether vaginally or section. Started in Ireland........thanks for
>>replying.
>>
--
Ronald E. Ainsworth, MD
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