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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 2

(570) Maternal and Neonatal Outcomes: Ampicillin Plus Gentamicin vs. Ampicillin Alone for Intrapartum Fever

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To evaluate the effectiveness of ampicillin plus gentamycin versus ampicillin alone in treating women with intrapartum fever.

Study Design: 10-year retrospective study at a single tertiary hospital, including term singleton vaginal deliveries who developed isolated intrapartum fever (≥38°C) without any concurrent evidence of infection. The department's treatment protocol changed in 2016 from ampicillin alone to ampicillin plus gentamicin. Primary outcome was puerperal endometritis. Secondary outcomes included microbiological studies, such as maternal urine or blood cultures, and neonatal outcomes.

Results:

A total of 389 women met inclusion criteria and were treated with either ampicillin alone (n=128, 33%) or ampicillin plus gentamycin (n=261, 67%). The incidence of endometritis was higher in the ampicillin group compared to the ampicillin plus gentamycin group, although not statistically significant (6.25% vs. 2.30%, P=0.08). Blood and urine culture positivity rates were similar (6.25% vs. 4.60%, p=0.47, 2.34% vs. 5.36%, p=0.20 respectively). Maternal hospitalization was longer for the ampicillin group (3.36 ± 1.1 days vs. 3.03 ± 1.04 days, P< 0.01).

Neonatal intensive care unit (NICU) admission rates were significantly higher in the ampicillin group (36.7% vs. 11.9%, P< 0.01). Conversely, among the neonates admitted to the NICU, the incidence of respiratory pathologies, such as respiratory distress syndrome or transient tachypnea of the newborn, and the need for ventilation were significantly higher in the ampicillin plus gentamycin group (2.1% vs. 25.8%, P< 0.01, 4.3% vs. 38.7 %, p< 0.01 respectively) (Table 1).

Conclusion:

Women treated with ampicillin alone for intrapartum fever had higher rates of adverse maternal outcomes compared to those treated with ampicillin plus gentamycin. Although NICU admission rates were higher in the ampicillin group, respiratory diseases were more prevalent in the ampicillin plus gentamycin group.