how likely is infection after water breaks?

[melmarie23, MSN, RN]

I've heard that the incidence or risk for infection increases with the number of pelvic exams performed. However, many of my pregnant friends believe that the baby has to be out within 24 hours after the water breaks dt the risk of infection and I just don't really believe that to be all that true. I don't deny that it can happen, but the likelihood of it happening is slim.

Are there any good reads to support this?

Thanks in advance.

[beachmom]

I've wondered that too. How likely is an infection with birth greater than 24 hours after water breaking. At my hospital they are induced if their water breaks and no labor starts. If it goes past 24 hours, they are usually sectioned for failure to progress, even if they are progressing slowly.

Is the infection risk worse than the risks of C/S? We also watch the babies for infection a lot closer. How bad is their risk?

Before the water breaks, I can't imagine checking a woman would increase infection much. After all, we don't encourage a woman to not have any sex, and that has to be more germy than a sterile glove. We do, at my hospital, limit the number of checks, regardless of whether the water is intact or not.

I'm a nursery nurse, soon to be training in labor.

[CEG]

I don't have the specific data in front of me so I can give you generalizations.

The risk of infection is relative to the type of care. A woman having a homebirth with no lady partsl exams has an extremely low risk of infection. A woman having a hospital birth with many lady partsl exams has a high risk of infection. The others fall somewhere in between. This is true whether membranes are ruptured or intact, but of course the risk of infection is higher with ruptured membranes.

There is no science to support the 24 hour rule. It is also not at all consistent, some places it is 12, some 24 others 18, none evidence-based. At my facility we assess according to risk and pt desire. If a pt wants a natural birth and wants to wait, we wait for labor (for about 12 hours, maybe 15, then the attendings get antsy). If a patient doesn't care then we start pit.

The thing about infection is that it tends to make labor dysfunctional. Typically if our moms start to show symptoms we treat with antibiotics and watch with no time limit unless mom or baby start to show signs of intolerance.

[melmarie23, MSN, RN]

thanks for your responses. Everything that I've read has basically said the same that you all just told me. Thanks for the confirmation. :-)