SAFETY OF SPINAL AND EPIDURAL-ANESTHESIA IN PARTURIENTS WITH CHORIOAMNIONITIS

Background and Objectives. The safety of spinal and epidural anesthesi a in patients with chorioamnionitis was explored. Methods. A retrospec tive study was made of the charts of 517 parturients who had received epidural anesthesia and 14 who had received spinal anesthesia before d elivery and whose placentas had subsequently been found to be positive for chorioamnionitis. Results. Of the 146 blood culture results that were reported, 13 were positive. Of these 13 blood cultures, 5 had bee n drawn within 6 hours after placement of the epidural block, and four of the five bacteremic patients did not receive antibiotics until aft er the regional anesthetic was administered. One quarter (11/45) of th e patients who were febrile and three quarters (174/229) of those who had leukocytosis before their block received no antibiotics before the block was placed. After the epidural block was performed, the cathete r was left in place for over 24 hours in 18% (46/260) of the women who spiked a fever and in 14% (18/130) of those who exhibited leukocytosi s during that period. There was no report of an epidural or spinal abs cess or of meningitis in any of the women in the study. Conclusion. Co nduction anesthesia may be safe in parturients with chorioamnionitis w ithout prior antibiotic therapy.