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Labor epidrual and ChorioFrom: Mark G. Newman (mgnewman@flash.net)Sun Oct 31 09:10:43 1999
Dear Listpersons: Please render some opinions about a situation that arose recently at one of the hospitals I practice in... A young woman was transferred to my institution with preterm PROM at 33+5 weeks. On arrival, she was contracting, had a temperature of 100.7, and had mild uterine tenderness. The diagnosis of chorioamnionitis was made, and broad spectrum antibiotics and pitocin was begun. At cervical exam of 3/100/-1, the patient requested epidural anesthesia for labor pain. The anesthesiologist refused, stating that the patient had chorio, and thus epidural was contraindicated. A second, backup anesthesiologist also refused for the same reason. Am I missing something? The literature says nothing about chorio as a contraindication to epidural, only local infection at the site of puncture. Any others with experience or opinions?
-- Mark G. Newman, MD Perinatal Associates of Texas
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