The following is a summary of “Characteristics and Management of Chorioamnionitis at an Academic Centre in Ontario Before and After Implementation of an Order Set,” published in the March 2024 issue of Obstetrics and Gynecology by Kay et al.

This study aimed to examine the characteristics and management approaches associated with chorioamnionitis, a condition with profound implications for both maternal and neonatal health outcomes, both before and after the implementation of a clinical order set. Accurate diagnosis of chorioamnionitis poses challenges due to its varied presentation, and management strategies often vary among healthcare providers and institutions. Recognizing the potential of clinical order sets to standardize and enhance care delivery, this investigation sought to evaluate any discernible differences in the profiles of chorioamnionitis cases and their management protocols pre-and post-implementation of such a tool. 

Data from 76 cases before the order set’s introduction and 66 cases after that were analyzed through meticulous chart review, focusing on diagnostic criteria and management strategies. The findings revealed no significant disparities in baseline characteristics between the two groups, indicating a consistency in the patient population over time. Notably, while there was an increase in the prevalence of parturient tachycardia observed in cases after the order set’s implementation, the percentage of cases meeting Gibb’s criteria, a key diagnostic indicator for chorioamnionitis, remained consistent across both periods. Interestingly, the only notable divergence in management practices was observed in the choice of antibiotics, with no significant differences noted in the performance of blood cultures or placental examinations between the pre-and post-implementation cohorts. 

In conclusion, while adopting the order set did not appear to influence the diagnostic process for chorioamnionitis significantly, it did lead to a discernible alteration in antibiotic selection, suggesting a potential role in refining treatment approaches for this condition.

Source: sciencedirect.com/science/article/abs/pii/S1701216324002238