Chorioamnionitis occurs in 1% to 5% of term pregnancies and may complicate up to 25% of cases
of preterm labor. The traditional regimen used to treat intra-amniotic infection is
intravenous ampicillin 2g every 6 hours and intravenous gentamicin 1.5 mg/kg every 8 hrs
until delivery . In the past the recommendation has been that the antibiotics be continued
postpartum until 24-48 hours afebrile. More recent studies have looked at using a one time
dose of antibiotics after delivery vs treating until 24-48 hours afebrile. There have been no
studies comparing treatment of chorioamnionitis with antibiotics vs no treatment with
antibiotics postpartum. The aim of this study is to compare no treatment vs treatment with
one dose after a vaginal delivery and one dose of antibiotics vs a full course until 24 hours
afebrile after a cesarean delivery complicated by chorioamnionitis. The hypothesis is that
there will be no difference in outcome between the two groups in each arm. This is a
randomized study. Once the patient delivers she will be randomized to one of two groups in
each arm. First arm (vaginal delivery) A: no treatment, B: treatment with a one time dose of
ampicillin/gentamicin; Second arm (c/s) A: one dose of ampicillin/gentamicin/clindamycin, B:
treatment with ampicillin/gentamicin and clindamycin until 24 hours afebrile. The goal of the
study is to determine the optimal postpartum management of chorioamnionitis.