Ok, I may have spelled it wrong. We call it chorio on the unit. I am trying to get an understanding of it and its not covered well in my notes and at work we are always so busy there isn't much time.
I had a patient dx'd with it last night and likely will have her again today so I want to get into work knowing what is going on.
She was in labor, ROM, no progression. Epidural did not take, moved to Csect (I think for failure to progress) and then spinal did not take, finally went under general. I don't remember just now her GBS status.
Baby delivered, taken to NBN. Found to be tachypnic, but O2 sat well. Intermittent tachypnea seen by doctor, called prolonged transition, nurse told to watch and see.
Meanwhile mom comes out of OR w/ fever. Very painful abdomen.
She is started on Gent and Clinda, per protocol. But no one is calling it chorio. They are waiting to test placenta.
So I get report on mom, LD nurse calls NBN and tells her about fever, possible chorio that is not being called chorio. (I don't understand that)
Anyway, mom is afebrile when I get her, and stayed so the 4 hours or so that I cared for her. On a morphine PCA, pain very well controlled. Good urine output and tolerated my fundus exam about as well as anyone does post-csect.
Meanwhile, baby remains tachypnic, and transfers from NBN to Special care. Blood tests reaveal low whites and multiple bands.
So that means infection of some sort. Baby will receive 48h abx.
So here are my questions:
Is there a specific physiology of neonate that decreases wbc w/ infection vs adults who's wbc is elevated w/ infection? I am thinking its cause they are new, have not fought off infection before...I am not good w/ physiology lol.
I read on the web that chorio can lead to neuro problems such as cerebral palsy. Has anyone heard of this?
Finally, is chorio basically an infection of the amniotic fluid or the placenta, or both? And am I right in thinking that it can be caused by GBS or other vaginal infection? I had it in my head that there is another cause but I can't remember what exactly and I went thru my school notes to no avail. Is not a TORCH, right?
Thanks so much everyone!