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Can PROLONGED RUPTURE OF MEMBRANES cause infection in baby?

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If a baby shows signs of an infection 5 hours after birth but was administered antibiotics withinman hour of birth and the mother was on antibiotics throughout Labour whatbis the most likely cause if the infection: a) prolonged rupture of membranes, b) repeated attempts to cannulate with the same needle, c) strep b?


Category: Pediatrician

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Category: ICU/ Critical Care Specialist
Dr. Saptharishi L G is online now

Expert:  Dr. Saptharishi L G replied 4 Days.

Dear Parent,
Thank you for your query at DoctorSpring.com
That is a very interesting question and merits a detailed response. Let me break it down to help you understand the context better.
1. Baby showing signs of infection at 5 hours of life means that the infectious organism has been multiplying inside the baby for at least 24- 48 hours prior to that. This means that infection is not acquired at the time of birth.. It has been acquired prior to that.
2. Administration of antibiotics within an hour of birth again means that you and your baby had significant RISK FACTORS for a pre-natal infection like features of CHORIO-AMNIONITIS (fever, elevated heart rate, foul smelling liquor, prolonged rupture of membranes, etc). That is the reason any baby would receive antibiotics at birth.
3. Mother being on antibiotics throughout labour reduces the risk of transmission of infection to the baby but DOES NOT MAKE IT ZERO.. because one cannot cover for every single bacteria or virus in the world. One usually covers for Streptococci.. There are numerous other organisms that can cause perinatal infections and one cannot give antibiotics that cover all of them, unless you have a specific organism on the urine/ amniotic fluid/ blood/ cervical swab culture
4. Repeated attempts to cannulate the baby with the same needle can lead to infections if not done with strict aseptic precautions. This means breach of hand hygiene protocols or use of a contaminated needle, etc. But, even of you assume that infection was transmitted in the process. The bacteria has to get into the baby and multiply to sufficient numbers and elicit a systemic inflammatory response, that we call the infection. This process usually takes a minimum of 24-48 hours [unless someone has injected the baby knowingly with a large load of bacteria (like an infected blood transfusion, etc..). In today's world, the last extreme example is extremely uncommon unless you are in a suburb of Africa with ZERO healthcare standards]
Relax.. Sometimes despite all precautions, prolonged rupture of membranes can lead to transmission of infection to the baby. It needs to be treated with appropriate antibiotics. It would be useful to focus your energies on treatment of the newborn.
Good luck and happy motherhood/ fatherhood.
Regards
Dr. Saptharishi L G
Dr. Saptharishi L G


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
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