INTRAUTERINE

INFECTION
BY: TIMOTHY METH S. CHU

Assessment

Assess the FHR and maternal vital signs for evidence of

infection:

Fetal tachycardia (160> bpm for a term fetus); a rising

baseline FHR often is the first sign of intrauterine
infection.

Maternal temperature; assess q 2-4 hrs in normal labor

& q 2 hrs after membranes rupture; assess hourly if
elevated (38C or ) or other signs of infection are
present.

Maternal PR, RR, and BP, assess at least q1 hr to

identify tachycardia or tachypnea.

Assess Amniotic fluid for normal clear color and mild

odor. Small flecks of white vernix are normal in
amniotic fluid. Yellow or cloudy fluid/fluid with a strong
odor suggests infection. (The strong odor may be noted
before birth or afterward on the infants skin.)

Nursing Diagnosis

For the woman w/o signs of infection but with risk

factors, the nursing diagnosis selected is Risk

for Infection related to presence of favorable
conditions for development. The nurse may
specify the patient specific conditions that may
cause infection when choosing this nursing
diagnosis.

Planning

Expected outcomes relate to detecting the onset

of infection:
Maternal temp. will remain 38C.
The FHR will remain near the baseline with an
average rate higher than 160 bpm.
The amniotic fluid will remain clean and
without a foul or strong odor.

Interventions

Reducing the Risk for

Infection

Wash hands before and after each contact with all patients
to reduce transmission of organisms.

Limit vaginal examinations to reduce transmission of vaginal

microorganisms -> uterine cavity, and maintain aseptic
technique during essential vaginal examinations.

Nurse is able to estimate a womans progress with few

vaginal examinations. (e.g. bloody show and heightened
anxiety may occur when the cervix is about 6 cm dilated. The
woman may become irritable and lose control at about 8 cm
dilation if she has chosen not to take epidural analgesia)

Keep underpads as dry as possible to reduce the moist ,

warm environment that favors bacterial growth.

Periodically clean excess secretions @ vaginal area in a front-toback direction to limit fecal contamination and promote the
mothers comfort.

Identifying the infection

Increase frequency of assessments is labor is

prolonged.

If signs of infection are noted, report them to the birth

attendant for further evaluation and treatment.

Collection of specimen from the uterine cavity or

placenta for culture to identify infectious
organisms and determine antibiotic sensitivity.

Transport specimens to the laboratory promptly.

Antibiotic therapy is started promptly after

collecting specimens.

Evaluation

The goals and expected outcomes are achieved if

the following occur:

The womans temperature remains 38C.
Amniotic fluid has no normal characteristics
that are typical of infection (cloudiness, yellow color,
foul or strong odor).
FHR remains within the expected range, no
tachycardia