Repost: Clostridium difficile and pregnancy - MD with knowledge please respond.

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I am a cerclage patient with a history of loss at 25 weeks due to chorioamnionitis. Because of this history and signs of PTL.. I was put on IV clindamycin at 24 weeks during this pregnancy. I am now 34 weeks. I have been experiencing moderate diarrhea (3-4 times per day) for about 11 days now. Today, it has let up and seems to be clearing. Along with the diarrhea I had terrible nausea that also seems better. However, I did submit a stool sample a few days ago - which came back positive for c.dif today. I started taking Metronidazole, 250 m.g. p.o. t.i.d. today. I have taken two doses. My last bowel movement was solid but a dark black-green color. My question is 1.) Is this treatment adequate or should I be taking 500 m.g. qid? 2.) Can the endotoxin A that is produced by this infection cross the placenta and harm my baby? 3.) Have you treated this before in pregnancy and what is your general experience regarding resolution of the infection? I am concerned that if I am being undertreated I am increasing my chances of going septic from this... the only medical history I have is incompetent cervix, otherwise I am healthy to the best of my knowledge. Oh and lastly, are the effects of metronidazole on the fetus relatively benign or is this an issue as well? Thanks, LD

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