INFEKSI INTRAUTERIN Chorioamnionitis o Plg srg o/ : Bacteroides Prevotella species E.

E. coli Anaerobic streptococci Group B streptococci o Risiko : Umur muda o Status ekonomi << nulipara waktu kelahiran lama Inf. genital

Diag : Maternal fever Maternal and fetal tachycardia Uterine tenderness Purulent amniotic fluid test WBC ibu Amniotic fluid glucose Amniotic fluid IL-6 Amniotic fluid Abnormal >15.000 sel/mm2 < 10 15 mm/dL >7.9 ng/Dl Ada organism

Dd :

ISPA Bronchitis Pneumonia Pyelonephritis Viral syndrome Appendicitis Bacteremia (ibu) Wound infection Abses pelvis Pneumonia + bacteremia ( bayi) Mortalitas bayi Antibiotic IV Ampicillin 2 g / Penicillin 5 million units q 6 jam Gentamicin 1.5 mg/kg tiap 8 jam

Komp :

Ttl :

Alergi antibiotic beta laktam (ampi/penisilin) Vancomycin 500 mg / 6jam or 1 g / 12jam Erythromycin 1 g / 6jam Clindamycin 900 mg / 8jam + anti-anaerobic antibiotic o o Clindamycin 900 mg / 8jam Metronidazole 500 mg / 6hr

Pasien chorioamnionitis pgn SC

o o

Teruskan antibiotic IV smp afebril dan asimpton slm 24 jam

Postpartum (puerperal) endometritis SC > pervaginam Etio : (plg umum) o Gejala : o Dd : Endometritis Viral syndrome Atelectasis Pyelonephritis Pneumonia Appendicitis demam >/= 38C slm 36 jam pertama Malaise, tachycardia, lower abdominal pain, uterine tenderness, discolored, malodorous lochia Group B streptococci Anaerobic streptococci (Peptostreptococci) Aerobic gram-negative bacilli (E.coli, Klebsiella) pneumoniae, Proteus species Anaerobic gram-negative bacilli (Bacteroides, Prevotella) Chlamydia late-onset infection

Ttl : antibiotik Regimen 1 Clindamycin Gentamicin dosis 900 mg /8jam 1.5 mg/kg /8jam or 5-7 mg/kg bb/ 24jam

Regimen 2 Clindamycin Aztreonam Regimen 3 Metronidazole Penicillin or Ampicillin Gentamicin

900 mg /8jam 1-2 g /8jam

500 mg /12jam 5 million units / 6jam 2 g / 6jam 1.5 mg/kg / 8jam 5-7 mg/kg bb / 24 jam