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.