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Foul Smelling Amniotic Fluid-lost article


mschwa

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I read an article about 10 years ago that suggested that foul smelling amniotic fluid was NOT a strong risk factor for sepsis (I remember this well because this went against my residency teaching-either that or I am losing my faculties!). The article stated the smelliest bugs at delivery were not usually the ones that caused the most trouble in infants. Am I losing my mind or can anyone else recall this?

I often teach students and I want to have my facts straight. I was able to find a few studies with small samples that listed smelly fluid as a risk factor. On the Cochrane database the article on neonatal sepsis lists chorioamnionitis as a risk but says nothing specifically about smelly fluid.

Thanks, Mike

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  • 2 weeks later...

Foul smelling amniotic fluid was one of the significant risk factors for sepsis in studies by Shah GS et. al. (Kathmandu Univ Med Journal 2006; 4:2 (14): 187-191) and Betty C (Indian J Pediatr 2005; 72:23-26) and is considered a major risk factor for sepsis in my centre in Enugu, Nigeria. I think that teaching stands, and of course it does parallel maternal chorioamnionitis.

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From memory -only One reterospective study with large numbers from Harbor-UCLA showed foul smelling as a minor risk. In this old study (~25-30 years back) they assigned 1, 2 or 3 number to low , mod and high risk facors and patient above certains numbers (total) were treated.

Dr Hodgeman from LACounty - USC used to say "anerobic infections cause foul smelling but not neonatal sepsis and GBS-Ecoli do not smell"

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