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Postpartum Endometritis

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201. 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

202. Chlorhexidine Gluconate vs Povidone-Iodine Vaginal Cleansing Solution Prior to Cesarean Delivery

: Richmond University Medical Center Information provided by (Responsible Party): Nisha Lakhi, MD, Richmond University Medical Center Study Details Study Description Go to Brief Summary: Endometritis, an infection of the uterus in the postpartum period, has been shown to complicate the postoperative course of a cesarean delivery in 6% to 27% of cases. Vaginal cleansing prior to cesarean delivery has been shown to minimize the presence of micro-organisms and risk of infection. Although povidone-iodine (...) with 4% chlorhexidine gluconate prior to non-emergent cesarean section. Outcome Measures Go to Primary Outcome Measures : Postoperative wound infection [ Time Frame: 0-14 days postpartum ] Erythema surrounding the incision site or pus-like incisional drainage in the presence or absence of fever Secondary Outcome Measures : Postpartum endometritis [ Time Frame: 0-14 days post-partum ] Clinical diagnosis with temperature of 100.4 degrees F or higher occurring 24 hours after surgery with uterine fundal

2016 Clinical Trials

203. Obesity: Cesarean Health by Incision Placement

diabetes and presence of pannus. The study will be assessed by intention-to-treat analysis looking composite maternal morbidity (wound complications within 6 weeks, endometritis, postpartum hemorrhage) as the primary outcome with secondary outcomes including wound complications, operative time, estimated blood loss, pain management, and patient and surgeon satisfaction. Significant confounders will be assessed and adjusted in the multiple regression analysis accordingly. Results: The investigators (...) iliac spines (higher than the Pfannenstiel incision). Should a pannus exist, the pannus should be left in the physiologic location (not retracted) to allow placement of the incision. Outcome Measures Go to Primary Outcome Measures : Composite Maternal Morbidity [ Time Frame: 18 months ] To compare composite maternal morbidity (wound complications within 6 weeks including cellulitis, wound abscess, wound separation or dehiscence, hematoma, seroma formation, endometritis, postpartum hemorrhage

2016 Clinical Trials

204. Early Amniotomy Versus Delayed Amniotomy Following Foley Catheter Ripening in Nulliparous Labor Induction

experience a decrease in their labor time when undergoing early amniotomy (breaking the bag of water within 1 hour of Foley catheter removal) than when undergoing delayed amniotomy (breaking the bag of water at least 4 hours after Foley catheter removal). Other aims include the relationship between timing of amniotomy and cesarean section, postpartum hemorrhage, intrauterine infection, neonatal Apgar score <7 at 5 minutes, neonatal need for intensive care. The investigators hypothesize that induction (...) degrees Celsius or >/= 38 degrees Celsius on two occasions greater than 30 minutes apart and at least one of the following: Fetal tachycardia (defined as sustained (>10 min) fetal heart rate >160), White Bood Cell Count >15, purulent fluid from cervical os, or receipt of antibiotics and diagnosis written in the chart Postpartum Fever [ Time Frame: From time of delivery to time of hospital discharge; up to 6 weeks ] Temperature >/= 38 degrees celsius on 2 separate occasions greater than 6 hours apart

2016 Clinical Trials

205. Outpatient Foley For Starting Induction of Labor at TErm

. ] Rates of cesarean delivery [ Time Frame: Assessed from baseline to delivery. ] Rates of operative vaginal delivery [ Time Frame: Assessed at delivery. ] Postpartum hemorrhage [ Time Frame: Assessed at delivery. ] Rates of endometritis [ Time Frame: Assessed from delivery until 30 days post-discharge. ] Rates of hospital readmission within 30 days [ Time Frame: Assessed from time of discharge until 30 days post-discharge. ] Rates of 5-minute Apgar < 7 [ Time Frame: Assessed at time of delivery up

2016 Clinical Trials

206. Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH

: two days after delivery ] nausea between delivery and discharge vomiting between birth and discharge headache between birth and discharge dyspnoea between birth and discharge Chest pain between birth and discharge endometritis after delivery (assessed by monitoring body temperature) Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding (...) Participant Data (IPD) Sharing Statement: Plan to Share IPD: Undecided Keywords provided by Azienda U.S.L. 1 di Massa e Carrara: TXA PPH Additional relevant MeSH terms: Layout table for MeSH terms Hemorrhage Postpartum Hemorrhage Pathologic Processes Obstetric Labor Complications Pregnancy Complications Puerperal Disorders Uterine Hemorrhage Oxytocin Tranexamic Acid Oxytocics Reproductive Control Agents Physiological Effects of Drugs Antifibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms

2016 Clinical Trials

207. Maternal Outcomes associated with early preterm cesarean delivery. (PubMed)

(23 0/7-27 6/7 and 28 0/7-31 6/7 weeks' gestation).We conducted a multihospital retrospective cohort study of women undergoing cesarean delivery at 23 0/7 to 31 6/7 weeks' gestation from 2005 through 2014. Composite maternal outcome (postpartum hemorrhage, transfusion, endometritis, sepsis, wound infection, deep venous thrombosis/pulmonary embolism, hysterectomy, respiratory complications, and intensive care unit admission) was compared between classic and low transverse cesarean. Outcomes were (...) in maternal complications for classic cesarean versus low transverse cesarean between 23 0/7 and 27 6/7 weeks' gestation. However, between 28 0/7 and 31 6/7 weeks' gestation, classic cesarean was associated with increased risks of the composite maternal outcome (adjusted odds ratio, 1.95; 95% confidence interval, 1.10-3.45), transfusion (adjusted odds ratio, 2.42; 95% confidence interval, 1.06-5.52), endometritis (adjusted odds ratio, 3.23; 95% confidence interval, 1.02-10.21), and intensive care unit

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2016 American Journal of Obstetrics and Gynecology

208. Persistent Pain After Cesarean Delivery and Vaginal Delivery: A Prospective Cohort Study. (PubMed)

was significantly more common in women with a history of previous pain and among primiparous women in logistic regression analysis. The women with persistent pain had experienced more pain the day after cesarean delivery (P = .023) and during vaginal delivery (P = .030) than those who did not report persistent pain. Complications such as perineal trauma, episiotomy, vacuum extraction, endometritis, wound infection, or ante- or postpartum depression did not predispose women to persistent pain. Dyspareunia (...) Persistent Pain After Cesarean Delivery and Vaginal Delivery: A Prospective Cohort Study. Persistent pain after cesarean delivery and vaginal delivery has been the subject of only a few research articles. The primary outcome of our prospective study was the incidence of persistent pain and its association to mode of delivery. We also studied the nature and intensity of pain after delivery.A questionnaire was distributed on postpartum day 2 to 1052 women who had given birth vaginally and to 502

2016 Anesthesia and Analgesia

209. Maternal and infant outcomes among women vaccinated against pertussis during pregnancy (PubMed)

infant at a southeast Texas public hospital between November 1, 2012 and June 30, 2014. After excluding women who had inadequate prenatal care or who delivered at <27 weeks gestation, we used multivariable logistic regression analyses to compare 13 outcomes between those who did and did not receive the Tdap vaccine. We examined 6 maternal outcomes (chorioamnionitis, postpartum endometritis, preterm delivery, preterm premature rupture of membranes, induced labor, and mode of delivery) and 7 infant

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2016 Human vaccines & immunotherapeutics

210. Signal transducer and activator of transcription-3 licenses Toll-like receptor 4-dependent interleukin (IL)-6 and IL-8 production via IL-6 receptor-positive feedback in endometrial cells (PubMed)

Signal transducer and activator of transcription-3 licenses Toll-like receptor 4-dependent interleukin (IL)-6 and IL-8 production via IL-6 receptor-positive feedback in endometrial cells Interleukin 6 (IL-6), acting via the IL-6 receptor (IL6R) and signal transducer and activator of transcription-3 (STAT3), limits neutrophil recruitment once bacterial infections are resolved. Bovine endometritis is an exemplar mucosal disease, characterized by sustained neutrophil infiltration and elevated IL-6 (...) and IL-8, a neutrophil chemoattractant, following postpartum Gram-negative bacterial infection. The present study examined the impact of the IL6R/STAT3 signaling pathway on IL-8 production by primary endometrial cells in response to short- or long-term exposure to lipopolysaccharide (LPS) from Gram-negative bacteria. Tyrosine phosphorylation of STAT3 is required for DNA binding and expression of specific targets genes. Immunoblotting indicated constitutive tyrosine phosphorylation of STAT3

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2016 Mucosal immunology

211. Impact of HIGH BMI on Pregnancy: Maternal and Foetal Outcome (PubMed)

analysis was carried out.Antepartum variables: prolonged pregnancy (<0.05), severe PIH (<0.05), PPROM (<0.05), gestational DM (<0.05) and anaemia (<0.05) are strongly associated with raised BMI, whereas abortion (>0.05), oligohydramnios (>0.05), UTI (>0.05) and abruption (>0.05) are not associated with raised BMI. Postpartum variables: PPH (<0.05), pyrexia (<0.05), prolonged hospital stay (<0.05) and lactational dysfunction (<0.05) are strongly associated with raised BMI, whereas UTI (>0.05 (...) ), thrombophlebitis (>0.05) and endometritis (>0.05) are not associated with raised BMI. BMI Neonatal outcome: IUGR (<0.05), preterm (<0.05), postterm (<0.05), LBW (<0.05) and macrosomia (>0.05) are strongly associated with raised BMI, whereas stillbirth (>0.05), intubation (>0.05), RDS (>0.05) and baby died within 24 (>0.05) are not associated with raised BMI.Overweight and obesity are risk factors for AP/IP/PP complication.

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2016 Journal of obstetrics and gynaecology of India

212. Glucose Availability and AMP-Activated Protein Kinase Link Energy Metabolism and Innate Immunity in the Bovine Endometrium (PubMed)

Glucose Availability and AMP-Activated Protein Kinase Link Energy Metabolism and Innate Immunity in the Bovine Endometrium Defences against the bacteria that usually infect the endometrium of postpartum cattle are impaired when there is metabolic energy stress, leading to endometritis and infertility. The endometrial response to bacteria depends on innate immunity, with recognition of pathogen-associated molecular patterns stimulating inflammation, characterised by secretion of interleukin (IL

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2016 PloS one

213. The Optimal Time for Intravenous Antibiotic Prophylaxis in Elective Cesarean Section

: April 19, 2016 Last Update Posted : April 19, 2016 Sponsor: Cairo University Information provided by (Responsible Party): Moutaz Sherbini, Cairo University Study Details Study Description Go to Brief Summary: Objective: To determine the optimal time for intravenous antibiotic prophylaxis administration in pregnant women undergoing elective cesarean section to minimize postpartum infectious complication for both the mother & neonate. Study Design: A randomized comparative study. Setting (...) ) immediately with skin incision & group C in which 200 women will receive IV ceftriaxone (2g) immediately after umbilical cord clamping. Outcomes include postoperative maternal & fetal infectious morbidity. Condition or disease Intervention/treatment Phase Endometritis Drug: ceftriaxone Phase 2 Detailed Description: Six hundred pregnant women aged from 20 to 40 years old with singleton living healthy fetuses undergoing elective lower segment caesarean section (LSCS); defined as LSCS done before onset

2016 Clinical Trials

214. Does a Rescue Course of Betamethasone in Pregnant Women With PPROM Decrease Neonatal Morbidity?

from the hospital and up until 6 weeks postpartum, or through study completion ] Chorioamnionitis will be defined as at least one temperature elevation above 38°C combined with at least two of the following signs: maternal or fetal tachycardia, uterine tenderness, foul smelling vaginal discharge, white blood count > 18,000. Postpartum endometritis will be defined as postpartum temperature elevation above 38°C without other localizing sources of infection and with either uterine tenderness or foul

2016 Clinical Trials

215. Association between Hospital Birth Volume and Maternal Morbidity among Low-Risk Pregnancies in Rural, Urban and Teaching Hospitals the United States (PubMed)

, we identified 508,146 obstetric deliveries meeting low-risk criteria and compared outcomes across hospital volume categories. Outcomes include postpartum hemorrhage (PPH), chorioamnionitis, endometritis, blood transfusion, severe perineal laceration, and wound infection. Results Hospital birth volume was more consistently related to PPH than to other maternal outcomes. Lowest-volume rural (< 200 births) and non-teaching (< 650 births) hospitals had 80% higher odds (adjusted odds ratio [AOR

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2016 American journal of perinatology

216. Single dose versus multiple dose of antibiotic prophylaxis in caesarean section: a systematic review and meta-analysis. (PubMed)

. Nonsignificant differences were observed between single dose and multiple dose antibiotic prophylaxis in the incidence of postpartum infectious morbidity (RR 0.95, 95% CI 0.75-1.20, I2 = 25%), endometritis (RR 1.03, 95% CI 0.74-1.42, I2 = 0%) and wound infection (RR 1.22, 95% CI 0.72-2.08, I2 = 0%). A trend towards lower risk of urinary tract infection was seen with multiple dose (RR 0.65, 95% CI 0.34-1.24, I2 = 0%).There was insufficient evidence to determine whether there is a difference between single

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2016 BJOG : an international journal of obstetrics and gynaecology

217. Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial. (PubMed)

Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial. To assess the effects of mechanical dilatation of the cervix during cesarean section on postoperative morbidity.A total of 447 women with elective cesarean section were included in the Dondi trial (Dilatation or no dilatation of the cervix during cesarean section). The primary outcome measure of this randomized controlled trial was postpartum hemorrhage (PPH) within 6 weeks (...) . Infectious morbidity (puerperal fever, endometritis, wound infection, and urinary tract infection), blood loss (need for blood transfusion or change in hemoglobin levels), and operating time were also evaluated.The rate of PPH within 6 weeks was not different between the two groups [dilatation group: 5 (2.4 %), no dilatation group: 3 (1.2 %), p = 0.479]. Infectious morbidity, blood loss, and operating time were not diverse as well. The only significant difference between the two groups was the rate

2016 Archives of gynecology and obstetrics Controlled trial quality: uncertain

218. Pleiotropic effects of negative energy balance in the postpartum dairy cow on splenic gene expression: repercussions for innate and adaptive immunity (PubMed)

Pleiotropic effects of negative energy balance in the postpartum dairy cow on splenic gene expression: repercussions for innate and adaptive immunity Increased energy demands to support lactation, coupled with lowered feed intake capacity results in negative energy balance (NEB) and is typically characterized by extensive mobilization of body energy reserves in the early postpartum dairy cow. The catabolism of stored lipid leads to an increase in the systemic concentrations of nonesterified (...) fatty acids (NEFA) and beta-hydroxy butyrate (BHB). Oxidation of NEFA in the liver result in the increased production of reactive oxygen species and the onset of oxidative stress and can lead to disruption of normal metabolism and physiology. The immune system is depressed in the peripartum period and early lactation and dairy cows are therefore more vulnerable to bacterial infections causing mastitis and or endometritis at this time. A bovine Affymetrix oligonucleotide array was used to determine

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2009 Physiological genomics

219. An unusual cause of delayed postpartum haemorrhage following caesarean section. (PubMed)

An unusual cause of delayed postpartum haemorrhage following caesarean section. Although less common in the UK, postpartum haemorrhage (PPH)--defined as blood loss of 500 ml or more within the first 24 h of delivery--remains a significant cause of maternal death worldwide. Haemorrhage between 24 h and 6 weeks post partum is termed "delayed PPH". Common causes include retention of gestational products or endometritis. Bleeding can be sudden and profound, resulting in rapid cardiovascular

2009 Emergency Medicine Journal

220. A Pilot Study of Early Postpartum Intrauterine Contraception

A Pilot Study of Early Postpartum Intrauterine Contraception A Pilot Study of Early Postpartum Intrauterine Contraception - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Pilot Study of Early Postpartum (...) clinical trial to evaluate placement of the levonorgestrel-releasing intrauterine contraceptive 10 minutes - 48 hours postpartum. Condition or disease Intervention/treatment Phase Unplanned Pregnancy Drug: Levonorgestrel-Releasing Intrauterine Contraceptive System (LNG-IUS), 52 Mg, 5 Year Duration Phase 4 Detailed Description: This was a single arm cohort study of women who desired to receive a levonorgestrel releasing intrauterine system (LNG-IUS) within 48 hours of uncomplicated vaginal delivery

2009 Clinical Trials

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