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20 Posts

smalley
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02/25/08 - 11:48 AM

a 22 yr old primigravida comes to the hospital at term with regular,painful contractions.her prenatal course was unremarkable. she has a past h/o mitral valve prolapse with regurgitation.she takes no medicines an has no allergies.her cervix is 4 cm dilated and fetus is in vertex position.fhr is reassuring.
whats the most appropriate mgt of this woman
1 administer iv antibiotics throughout labour
2 administer iv antibiotics 30 min prior to delivery
3 administer iv antibiotics after the cord is clamped
4 administer iv antibiotics 6 hrs after the delivery
5 no antibiotic prophylaxis is neccessary

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ilanoearl
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02/25/08 - 12:13 PM

my guess is choice 1. rolling eyes

smalley
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02/25/08 - 09:10 PM

cmon on guys...... nod

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dermdoc57
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02/25/08 - 10:36 PM

It is choice 2.MVP with regurgitation is an indication for endocarditis prophylaxis.

smalley
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02/26/08 - 03:45 PM

helloooooooooooo

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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31

smalley
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02/26/08 - 10:18 PM

where are all shaking head

.......?no one seems to answer this.....the above two are wrong...
cmon guys do shed some light on this......i need some help for clarification.. nod

shahnaz.r
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02/27/08 - 01:23 PM

I'd go for 5 = NO antibiotic prophylaxis is necessary

As there is very very little chance infective endocarditis with normal vaginal delivery.

smalley
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Posts: 316

02/28/08 - 11:20 AM

mvp with mr is considered a mod risk. in case of vag or cs antibiotic prophylaxis is not indicated except in high risk categories like prosthetic valves etc..i got it
thanks

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But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31

Al Durra
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02/28/08 - 01:51 PM

if we assume that the patient has high risk for IEC , when should we administer the AB ??
A
B
C
or D

who know ? wink

inkspot
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02/29/08 - 10:15 AM

#10

i know this has been answered but my answer was 5.

MVP + regurg = mod risk ( true)

but give prophylaxis for dental (oral) GI top to bottom. and urinary manipulations only.
Please correct me if there is another thing more to it.

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shahnaz.r
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02/29/08 - 03:32 PM

#11

According to 2007 AHA guideline, IE prophylaxis is NOT needed routinely for uncomplicated vaginal delivary and CS. However, pregnancy may be complicated any time, even the episiotomy is not normal. So current practice provides IE prophylaxis to high risk pregnant women. The most important risk for IE is premature rupture of membrane.

Ref: UptoDate

Note: i didn't find specificaly when we should give the antibiotic prophylaxis. shaking head

inkspot
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03/01/08 - 02:31 AM

#12

what is the answer buddy!

yes or no? give or not give?

make it simple.

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smalley
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03/01/08 - 11:50 PM

#13

inkspot ive already told the answer in my previous post
shahnaj is rt..ie prophylaxis not given in uncomplicated or mod risk cases in vaginal or c/s deliveries
in case of high risk cases i think its antibiotics 30 min before delivery(i think kaplan qbank had a quest like this)correct me if am wrong
thanks every1 smiling face

inkspot
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03/02/08 - 04:01 AM

#14

agree

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Al Durra
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03/02/08 - 10:56 AM

#15

well , the answer is C to prevent the newborn from being exposed to unnecessary antibiotics because the ABs r given here to protect the mother rather than the baby . In contrast to GBS prophylaxis .

kaphoury
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03/13/08 - 01:39 PM

#16

i think that the answer is 2) adminster iv AB 30 min b4 delivery

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kaphoury
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03/13/08 - 01:51 PM

#17

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fafa
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04/11/08 - 12:14 AM

#18

Al Durra wrote:
well , the answer is C to prevent the newborn from being exposed to unnecessary antibiotics because the ABs r given here to protect the mother rather than the baby . In contrast to GBS prophylaxis .

Are you sure from this information ?? what is the source ??

ricardoricardo
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04/18/08 - 01:15 AM

#19

Markus2009
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04/18/08 - 06:28 AM

#20

NO ANTIBIOTIC NEEDED------>5

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