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Postpartum Endometritis

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181. Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. (PubMed)

will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death. Maternal morbidity from intraamniotic infection also can be significant, and may include dysfunctional labor requiring increased intervention, postpartum uterine atony with hemorrhage, endometritis, peritonitis, sepsis, adult respiratory distress syndrome and, rarely, death. Recognition of intrapartum intraamniotic infection

2017 Obstetrics and Gynecology

182. Risk Factors for Postcesarean Maternal Infection in a Trial of Extended-Spectrum Antibiotic Prophylaxis. (Full text)

received standard preincision prophylaxis and were randomized to receive azithromycin or placebo. The primary outcome for this analysis is maternal infection: a composite outcome of endometritis, wound infection (superficial or deep), or other infections occurring up to 6 weeks postpartum. Maternal clinical characteristics associated with maternal infection, after controlling for azithromycin assignment, were identified. These maternal factors were included in a multivariable logistic regression model

2017 Obstetrics and Gynecology PubMed

183. Antibiotic Prophlaxis for High-risk Laboring Women in Low Income Countries

of azithromycin, 1 gram of azithromycin+2 grams of amoxicillin or placebo. Women will be followed to ascertain maternal infectious outcomes and perinatal outcomes. Condition or disease Intervention/treatment Phase Postpartum Sepsis Postpartum Endometritis Postpartum Fever Drug: Azithromycin Drug: Azithromycin and amoxicillin Drug: Placebo Phase 4 Detailed Description: This 3-arm study is a large randomized clinical trial designed to evaluate the comparative effectiveness and safety of single dose oral (...) : Azithromycin and amoxicillin azithromycin and amoxicillin Other Name: azithromycin, amoxicillin Placebo Comparator: Usual Care This arm will consist of routine care at the clinical sites (which is usually no antibiotic). They will receive placebo (for azithromycin) and placebo (for amoxicillin) Drug: Placebo Placebo tablet Outcome Measures Go to Primary Outcome Measures : Peripartum infection [ Time Frame: Up to 6 weeks after delivery ] Maternal peripartum infection including chorioamnionitis, endometritis

2017 Clinical Trials

184. Use of Negative Pressure Wound Therapy in Morbidly Obese Women After Cesarean Delivery

of active phase, arrest of descent, malpresentation, repeat cesarean delivery, desired cesarean Reason for admission [ Time Frame: At the time of admission ] Spontaneous labor, rupture of membranes, induction of labor, scheduled cesarean delivery, fetal condition (oligohydroamnios, growth restriction, non reassuring fetal heart tracing) Labor duration [ Time Frame: At the time of cesarean delivery ] Endometritis [ Time Frame: Four weeks postpartum ] Length of rupture of membranes [ Time Frame (...) is typically removed on postoperative day one or two. The primary outcome is a wound complication defined as the formation of a wound infection, seroma, hematoma, separation, or dehiscence from delivery to 4 weeks postpartum. Investigators will also administer a patient satisfaction survey regarding their wound healing experience. Condition or disease Intervention/treatment Phase Obesity, Morbid Wound Infection Wound Complication Device: Negative pressure wound therapy (PREVENA Incision Management Therapy

2017 Clinical Trials

185. Intra-uterine Cleaning During Cesarean Section

will have their uterine cavities left alone after complete delivery of the placenta. The placenta will be inspected after delivery to make sure it is complete, including the membranes. Outcome Measures Go to Primary Outcome Measures : Postpartum endometritis [ Time Frame: Within weeks ] Endomyometritis after delivery [ Time Frame: Within 6 weeks after delivery ] Endomyometritis will be diagnosed by the presence of two or more of the following: abnormally tender uterus on examination, temperature more (...) in obstetric practice. The American College of Obstetricians and Gynecologists (ACOG) estimates that in 2011 alone, one in three women who gave birth in the United States did so by cesarean delivery. Compared to vaginal births, the increasing rate of caesarean births worldwide is a well known cause of maternal morbidity, including hemorrhage, anesthetic complications, shock, cardiac arrest, acute renal failure, assisted ventilation, venous thromboembolism and increased risk of major postpartum infection

2017 Clinical Trials

186. Oxytocin Dosing at Planned Cesarean Section and Anemia

of LR. Women who receive the standard 20 mU of oxytocin in 1L of LR in bolus fashion plus 20 mU in 1L over 8 hours will have decreased blood loss by weight in the postpartum period compared to patients who receive 20 mU in 1L of LR. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 0 participants Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description: Randomized double-blinded controlled (...) Masking: Double (Participant, Investigator) Masking Description: Covering of labels on IV fluids Primary Purpose: Prevention Official Title: Oxytocin Dosing at Planned Cesarean Section and Postpartum Anemia: A Comparison of Two Protocols Estimated Study Start Date : March 1, 2019 Estimated Primary Completion Date : March 1, 2020 Estimated Study Completion Date : March 1, 2020 Resource links provided by the National Library of Medicine related topics: available for: Arms and Interventions Go to Arm

2017 Clinical Trials

187. Tranexamic Acid for the Prevention of Obstetrical Hemorrhage After Cesarean

review, whose onset is after randomization Postpartum infectious complications [ Time Frame: within 6 weeks postpartum ] Infectious complications such as: endometritis, surgical site infection, pelvic abscess Admission to the intensive care unit for more than 24 hours [ Time Frame: within 6 weeks postpartum ] Any admission to the intensive care unit that lasts more than 24 hours Maternal death [ Time Frame: within 6 weeks postpartum ] Use of uterotonics other than oxytocin [ Time Frame: within 48 (...) : February 20, 2019 See Sponsor: The George Washington University Biostatistics Center Collaborator: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Information provided by (Responsible Party): The George Washington University Biostatistics Center Study Details Study Description Go to Brief Summary: A randomized placebo-controlled trial of 11,000 women to assess whether tranexamic acid as prophylaxis lowers the risk of postpartum hemorrhage in women undergoing

2017 Clinical Trials

188. Novii External Fetal Monitoring Device

Nursing time required for care: [ Time Frame: Time of randomization until time of delivery (up to 48 hours) ] Nurses will record the time and reasons that they enter the room Overall cost of care: [ Time Frame: Hospitalization for labor, delivery, and recovery - 2-4 days ] Total charge for care from admission to Labor and Delivery to transfer to postpartum care will be recorded for all patients Overall cost of care: [ Time Frame: Hospitalization for labor, delivery, and recovery - 2-4 days ] Delivery (...) or triple I) [ Time Frame: Hospitalization for labor, delivery, and recovery - 2-4 days ] Infections documented Maternal outcomes - Presence of clinical endometritis [ Time Frame: Hospitalization for labor, delivery, and recovery - 2-4 days ] Endometritis diagnosis recorded Neonatal outcomes - APGAR Scores [ Time Frame: Hospitalization after delivery - 2-4 days ] APGAR scores recorded at 1 minute, 5 minutes, and 10 minutes Neonatal outcomes - Need for ICU Admission [ Time Frame: Hospitalization after

2017 Clinical Trials

189. A proof-of Concept, Randomized 3-month Study to Evaluate the Effects of Three Contraceptive Intrauterine Systems Delivering Copper and a Daily Dose of 5, 20 or 40 μg of Ulipristal Acetate (UPA)

of enrollment in this study. Use of injectable contraceptives during the previous 3 months (e.g. Cyclofem) or 6 months (e.g. DMPA). Women who do not have at least two progesterone measurements ≥10nmol/L during the baseline cycle will be excluded from further participation in the study (See Section 13.4.1) Acute pelvic inflammatory disease or a history of pelvic inflammatory disease unless there has been a subsequent intrauterine pregnancy. Postpartum endometritis or infected abortion in the past 3 months

2017 Clinical Trials

190. Randomized Control Trial of Intracervical Balloon Placement vs Oxytocin in Women With Term PROM and Unripe Cervices

with associated maternal or fetal tachycardia Endometritis [ Time Frame: from time of delivery until 2 days after delivery for vaginal deliveries and 3 days after delivery for cesarean sections ] temperature >100.4 F in the postpartum period with initiation of antibiotics in postpartum period Postpartum hemorrhage [ Time Frame: at time of delivery and up to 24 hours after delivery ] Estimated blood loss (EBL) >500 cc from a vaginal delivery and EBL >1000 cc from a cesarean delivery Epidural use [ Time Frame

2017 Clinical Trials

191. Prophylactic Antibiotics After Cesarean

standard of care Outcome Measures Go to Primary Outcome Measures : Surgical site infection [ Time Frame: 6 weeks postpartum ] Including superficial or deep incisional surgical site infection, endometritis, and other related infections, such as septic pelvic thrombophlebitis and abdominal or pelvic abscess Secondary Outcome Measures : Maternal mortality [ Time Frame: 6 weeks (42 days) postpartum ] Maternal death Febrile morbidity [ Time Frame: 6 weeks (42 days) postpartum ] If the patient develops (...) will be the administration of cephalexin and metronidazole post-operatively for 48 hours. The primary outcome measure will be surgical site infection (including superficial or deep incisional surgical site infection, endometritis, and other related infections, such as septic pelvic thrombophlebitis and abdominal or pelvic abscess) in the post-operative period. In order to most effectively and accurately analyze our primary and secondary research outcomes, the investigators will standardize our surgical operation

2017 Clinical Trials

192. Phytotherapy in Streptococcus agalactiae: An Overview of the Medicinal Plants Effective against Streptococcus agalactiae (Full text)

Phytotherapy in Streptococcus agalactiae: An Overview of the Medicinal Plants Effective against Streptococcus agalactiae Streptococcus agalactiae is a spherical and Gram-positive bacterium that causes postpartum sepsis, endometritis, chorioamnionitis and premature delivery in pregnant women. The use of herbs and natural ingredients for the treatment of various disorders has been common. The present review is a report on the medicinal plants with anti-Streptococcus agalactiae effects

2017 Journal of clinical and diagnostic research : JCDR PubMed

193. Bovine Endometrial Epithelial Cells Scale Their Pro-inflammatory Response In vitro to Pathogenic Trueperella pyogenes Isolated from the Bovine Uterus in a Strain-Specific Manner (Full text)

Bovine Endometrial Epithelial Cells Scale Their Pro-inflammatory Response In vitro to Pathogenic Trueperella pyogenes Isolated from the Bovine Uterus in a Strain-Specific Manner Among different bacteria colonizing the bovine uterus, Trueperella pyogenes is found to be associated with clinical endometritis (CE). The ability of cows to defend against T. pyogenes infections depends on the virulence of invading bacteria and on the host's innate immunity. Therefore, to gain insights into bacterial (...) factors contributing to the interplay of this host pathogen, two strains of T. pyogenes were included in this study: one strain (TP2) was isolated from the uterus of a postpartum dairy cow developing CE and a second strain (TP5) was isolated from a uterus of a healthy cow. The two strains were compared in terms of their metabolic fingerprints, growth rate, virulence gene transcription, and effect on bovine endometrial epithelial cells in vitro. In addition, the effect of the presence of peripheral

2017 Frontiers in cellular and infection microbiology PubMed

195. Insertion of a double balloon catheter for induction of labour in pregnant women without previous caesarean section

canal injury was reported in 1 woman and 5 women respectively in the DBC and prostaglandin gel groups (p=0.10) in the RCT of 126 pregnant women. 5.7 Intrapartum fever was reported in 8 and 2 women respectively in the DBC and SBC groups (p=0.10) in the RCT of 302 pregnant women comparing DBC (n=148) against SBC (n=145). 5.8 Postpartum endometritis after caesarean section occurred in 1 woman in the DBC plus oral misoprostol group (n=59) and in no women in the oral misoprostol alone group (n=63 (...) arterial pH: prostaglandin gel group 7.25, DBC group 7.26, SBC group 7.26; a single p value of 0.05 was cited) in an RCT of 330 nulliparous pregnant women. 5.5 There was no statistically significant difference in the incidence of postpartum haemorrhage (that is, more than 1000 ml blood loss) between the DBC, SBC and prostaglandin gel groups (DBC 5% [5/107], SBC 5% [5/110], prostaglandin gel group 11% [12/113]; a single p value of 0.143 was cited) in the RCT of 330 nulliparous pregnant women. 5.6 Birth

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

196. Breastfeeding. Evidence based guidelines for the use of medicines

Breastfeeding. Evidence based guidelines for the use of medicines clinical Lisa H Amir Marie V Pirotta Manjri Raval Breastfeeding Evidence based guidelines for the use of medicines Background General practitioners may consider prescribing medicines for breastfeeding women during the postpartum period. Most medicines can be used safely during breastfeeding at the recommended dose, however there are exceptions that necessitate caution. Objective This article provides an evidence based review (...) of medicines used for common situations and their compatibility with breastfeeding. Discussion Breastfeeding women typically use relatively few medicines, and generally these are compatible with breastfeeding. If other medicines are required, information on their safety during breastfeeding can be accessed from pharmacy departments at maternity hospitals or from online resources. Keywords: breastfeeding; postpartum; therapeutics In Australia, 50% of women breastfeed their babies for at least 6 months. 1

2011 Clinical Practice Guidelines Portal

197. Lactational mastitis and breast abscess. Diagnosis and management in general practice

Lactational mastitis affects approximately 20% of breastfeeding Australian women in the first 6 months postpartum. 7 It is most common in the first 6 weeks of breastfeeding 1,5 with the highest incidence occurring during the second and third weeks. 6,9 It is initially localised to one segment of the breast, but untreated can spread to affect the whole breast. 5 Around 3% of lactating women with mastitis will develop a breast abscess, 1,10 although an incidence of up to 11% has been reported. 10 Risk (...) factors and prevention The main risk factor for mastitis is breastfeeding during the early postpartum period. 6 Milk stasis and cracked nipples may contribute to the development of mastitis, 1,3–6 although the evidence for this is inconclusive. 1 Other implicated factors include previous mastitis, 6 maternal fatigue 1,3 and primiparity. 9 Reported risk factors for breast abscess include a past history of mastitis, maternal age over 30 years and gestational age greater than 41 weeks. 5

2011 Clinical Practice Guidelines Portal

198. Antimicrobial prophylaxis in caesarean section delivery (Full text)

Antimicrobial prophylaxis in caesarean section delivery Antimicrobial prophylaxis is used routinely for pre-, intra- and post-operative caesarean section. One of the most important risk factors for postpartum infection is caesarean delivery. Caesarean section shows a higher incidence of infection than vaginal delivery. It is complicated by surgical site infections, endometritis or urinary tract infection. The aim of the present study was to assess the usage of antimicrobials in women undergoing

2016 Experimental and therapeutic medicine PubMed

199. Immediate Versus Delayed Induction in Term-PROM Using or Not Antibiotic Prophylaxis

: Cefoxitin Drug: oxytocin/misoprostol Active Comparator: Immediate induction without antibiotic prophylaxis Immediate induction without antibiotic prophylaxis Drug: oxytocin/misoprostol Active Comparator: Delayed induction with antibiotic prophylaxis Delayed induction (>= 12 hours after PROM) with antibiotic prophylaxis Drug: Cefoxitin Drug: oxytocin/misoprostol Outcome Measures Go to Primary Outcome Measures : Maternal and neonatal infection rate [ Time Frame: intrapartum and immediate postpartum (...) Santa Maria, Portugal: term premature rupture of membranes, antibiotic prophylaxis, chorioamnionitis, endometritis, neonatal infection Additional relevant MeSH terms: Layout table for MeSH terms Infection Communicable Diseases Anti-Bacterial Agents Cefoxitin Antibiotics, Antitubercular Oxytocin Misoprostol Anti-Infective Agents Antitubercular Agents Oxytocics Reproductive Control Agents Physiological Effects of Drugs Abortifacient Agents, Nonsteroidal Abortifacient Agents Anti-Ulcer Agents

2016 Clinical Trials

200. Is More Than One Dose of Misoprostol Needed to Expedite Vaginal Delivery in a Patient With an Unripe Cervix?

hours, time from initiation of protocol to delivery and cesarean section rates will be compared. Complications such as postpartum hemorrhage, episodes of tachysystole with fetal compromise and chorioamnionitis and endometritis will be monitored. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 350 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment

2016 Clinical Trials

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