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Intra-amniotic infection — DRCOG MCQ

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HardIntrapartum CareIntra-amniotic infectionDRCOG

A 32-year-old woman in labour with an epidural develops temperature 38.5°C, uterine tenderness and foul-smelling liquor. Fetal heart baseline is 175 bpm. She is 6 cm dilated. What is the most likely diagnosis?

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Correct answer: E — Intra-amniotic infection

Maternal fever with uterine tenderness, offensive liquor and fetal tachycardia is most consistent with intra-amniotic infection. Epidural-related fever is a consideration, but the liquor and uterine tenderness make infection more likely. Placental abruption usually presents with pain, bleeding and uterine hypertonus rather than offensive liquor. The pearl is that maternal infection often declares itself through both maternal and fetal observations.

Reference: NICE NG235; NICE NG25