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Postpartum Endometritis

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221. Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. (PubMed)

endometritis (RR 0.50, 95% CI 0.18 to 1.38). However, significant decrease in the risk of chorioamnionitis (RR 0.29, 95% CI 0.10 to 0.82). No serious adverse effects were reported.Current evidence indicates that compared to placebo, antibiotics for MSAF in labour may reduce chorioamnionitis. There was no evidence that antibiotics could reduce postpartum endometritis, neonatal sepsis and NICU admission. This systematic review identifies the need for more well-designed, adequately powered RCTs to assess (...) assessed the results of the only available trial and extracted data on maternal and neonatal outcomes.We included one study with 120 pregnant women. It compared ampicillin-salbactam (N = 60) versus normal saline (N = 60) in pregnant women with MSAF. Prophylactic antibiotics appeared to have no statistically significant reduction in the incidence of neonatal sepsis (risk ratio (RR) 1.00, 95% CI 0.21 to 4.76), neonatal intensive care unit (NICU) admission (RR 0.83, 95% CI 0.39 to 1.78) and postpartum

2010 Cochrane

222. WITHDRAWAN. Antibiotic prophylaxis for cesarean section. (PubMed)

WITHDRAWAN. Antibiotic prophylaxis for cesarean section. The single most important risk factor for postpartum maternal infection is cesarean delivery.The objective of this review was to assess the effects of prophylactic antibiotic treatment on infectious complications in women undergoing cesarean delivery.We searched the Cochrane Pregnancy and Childbirth Group trials register (January 2002) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001).Randomized trials (...) comparing antibiotic prophylaxis or no treatment for both elective and non-elective cesarean section.Two reviewers assessed trial quality and extracted data.Eighty-one trials were included. Use of prophylactic antibiotics in women undergoing cesarean section substantially reduced the incidence of episodes of fever, endometritis, wound infection, urinary tract infection and serious infection after cesarean section. The reduction in the risk of endometritis with antibiotics was similar across different

2010 Cochrane

223. Management of Women with Obesity in Pregnancy

of a number of serious adverse outcomes, including miscarriage, 6 fetal congenital anomaly, 7 thromboembolism, 8,9 gestational diabetes, 10 pre-eclampsia, 11 dysfunctional labour, 12 postpartum haemorrhage, 10 wound infections, 10 stillbirth 13,14 and neonatal death. 14-16 There is a higher caesarean section rate 17 and lower breastfeeding rate 18 in this group of women compared to women with a healthy BMI. There is also evidence to suggest that obesity may be a risk factor for maternal death (...) discussion antenatally about possible intrapartum complications associated with a high BMI, and management strategies considered. This should be documented in the notes. Observational studies have shown that there is a higher incidence of intrapartum complications among women with obesity compared to women with a healthy weight. There is an increased risk of slow labour progression, 12,46 shoulder dystocia 15,20 and emergency caesarean section. 10,20 There is also an increased risk of primary postpartum

2010 Royal College of Obstetricians and Gynaecologists

224. Late Intrauterine Fetal Death and Stillbirth

on routine intrapartum antibiotic prophylaxis in this specific circumstance. No studies were found on the use of antibiotics for the prevention of maternal infection in women with a late IUFD. Intrapartum antibiotic prophylaxis for carriers of group B streptococcus is primarily intended to reduce the risk of neonatal infection. A large prospective study of group B streptococcus carriers in the USA showed that 2.0% of women developed postpartum endometritis. 124 6.6 Are there any special recommendations (...) of Child Health (NICH) study of 17 898 women with a live fetus undergoing VBAC, the maternal morbidity associated with VBAC (including induced and augmented labours) was a higher risk of endometritis (OR 1.62, CI 1.40–1.87), blood transfusion (OR 1.71, CI 1.41–2.08) and scar dehiscence/rupture (0.7%). There was no evidence of an increased rate of hysterectomy or maternal death. Of a subset of 4708 women who had had labour induced, 48 had scar problems (1%). 115 The Society of Obstetricians

2010 Royal College of Obstetricians and Gynaecologists

225. Prophylactic antibiotics effective for women undergoing caesarean section

of endometritis following both elective and nonelective caesarean section by two-thirds to three-quarters and the incidence of wound infection by up to three-quarters. Postpartum febrile morbidity and the incidence of urinary tract infections were also decreased. Fewer serious complications were identified. The administration of prophylactic antibiotics before or after clamping of the cord seemed equally effective for women undergoing caesarean section. The antimicrobial agents most often used in the trials

2011 Cochrane PEARLS

226. Cervical Ripening for Obese Women: A Randomized, Comparative Effectiveness Trial

: = Non-reassuring fetal heart tones (FHTs) = Maternal exhaustion = Other Composite maternal morbidity as indicated by the number of participants with measures of maternal morbidity [ Time Frame: Induction to discharge (approximately 5 days) ] Measures of maternal morbidity assessed: Maternal ICU admission Postpartum endometritis Surgical-site infections prior to discharge Venous thromboembolism Need for transfusion Maternal death Number of newborns admitted to the neonatal intensive care unit (NICU

2015 Clinical Trials

227. Effect of a Patient-Centered Decision App on TOLAC

, postpartum febrile morbidity (endometritis, cellulitis, urinary tract infection, or other infection), as noted in the medical record for her delivery. 3rd or 4th Degree Lacerations [ Time Frame: Collected 0 to 8 weeks after delivery. ] 3rd or 4th degree lacerations, as noted in the medical record for her delivery. Neonatal Death or HIE [ Time Frame: Collected 0 to 8 weeks after delivery. ] Stillbirth/fetal demise (antepartum or intrapartum), neonatal death, HIE, as noted in the medical record for her

2015 Clinical Trials

228. Comparison of Uterine Repair Methods for Cesarean Delivery

% of the baseline mean arterial pressure, despite a phenylephrine infusion Pelvic irrigation [ Time Frame: Intraoperative ] To determine if the patient had pelvic irrigation, yes or no Length of surgery [ Time Frame: Intraoperative ] Estimated blood loss [ Time Frame: Intraoperative ] Measuring suction canisters and wet sponges Reduction in hemoglobin [ Time Frame: Within 24 hours of surgery ] Difference between preoperative and postoperative hemoglobin within 24 hours of surgery Incidence of endometritis (...) provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Elective cesarean delivery Term gestation, 37 weeks or more Healthy parturients (ASA 1 and 2) Spinal anesthesia Exclusion Criteria: Conditions at risk of uterine atony and/or postpartum hemorrhage (multiple gestation, placenta accrete / previa, pre-eclampsia

2015 Clinical Trials

229. Preterm Premature Rupture of Membranes, Outpatient Management vs Inpatient Management

management patients will continue there treatment in hospital till delivery Outcome Measures Go to Primary Outcome Measures : rate occurence of Neonatal sepsis [ Time Frame: 48 hours after delivery ] proven neonatal infection with positive blood culture within 48 hours after birth, or culture proven neonatal pneumonia or meningitis Secondary Outcome Measures : rate of occurence of Maternal morbidity [ Time Frame: 48 hours after delivery ] including chorioamnionitis , endometritis , septicaemia, admission (...) to intensive care unit, organ failure, major postpartum hemorrhage 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 to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study

2015 Clinical Trials

230. Continued Versus Discontinued Oxytocin Stimulation of Labour

changed for a blinded infusion-set. Other Name: Isotonic saline Outcome Measures Go to Primary Outcome Measures : Caesarean section [ Time Frame: labour ] Frequency of acute performed caesarean sections Secondary Outcome Measures : Instrumental delivery [ Time Frame: 0-48 hours ] use of vacuum extraction or forceps for delivery Birth experience [ Time Frame: 4 weeks postpartum ] Childbirth Experience Questionaire (CEQ) Breastfeeding [ Time Frame: 0-6months ] Time to established feeding and duration (...) CTG Use of epidural analgesia [ Time Frame: 0-48 hours ] Dose and duration of oxytocin infusion [ Time Frame: 0-48 hours ] Use of episiotomy [ Time Frame: 0-48 hours ] Rupture of the anal sphincter [ Time Frame: 0-48 hours ] Uterine rupture [ Time Frame: 0-48 hours ] Volume of blood loss at delivery and postpartum [ Time Frame: 0-48 hours ] Need for evacuation of retained products of conception [ Time Frame: 0-48 hours ] Maternal use of antibiotics during labour [ Time Frame: 0-48 hours ] Maternal

2015 Clinical Trials

231. Intra-abdominal saline irrigation at cesarean section: a systematic review and meta-analysis. (PubMed)

post-operatively (RR = 1.84, 95% CI 0.21-2.78) when compared with controls. There were no significant differences between intraoperative saline irrigation and no treatment for post-operative emesis (RR = 1.65, 95% CI 0.74-3.67), estimated blood loss, time to return of gastrointestinal function, postpartum endometritis (RR = 0.95, 95% CI 0.64-1.40), urinary tract infection and wound infection.Intraoperative saline irrigation at cesarean delivery increases intraoperative and post-operative nausea (...) , requiring increasing use of anti-emetics without significant reduction in infectious, intraoperative and postpartum complications. Routine abdominal irrigation at cesarean section is not supported by current data.

2015 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

232. Vaginal Progesterone for the Prolongation of Pregnancy After Arrested Pre-term Labor

(specifically genital abnormalities). The rate of chorioamnionitis and endometritis [ Time Frame: around delivery and up to 1 week post-partum ] Adverse medication reactions [ Time Frame: Up to 13 weeks ] Postpartum hemorrhage [ Time Frame: From delivery and up to 1 week post-partum ] Revision of uterine and cervix and reasons for the procedure [ Time Frame: During the 48 hours from delivery ] Urinary tract or vulvovaginal infection until 36.6 weeks [ Time Frame: Up to 13 weeks ] Eligibility Criteria Go

2015 Clinical Trials

233. Mirena® IUD's Effect on Fallopian Tube Fimbriae and Ovarian Cortical Inclusion Cyst Cell Proliferation

surgery or who already have the Mirena® in place Women using non-hormonal forms of contraception (Note: If a copper IUD is being used, the IUD must be removed prior to or at time of Mirena insertion.) Exclusion Criteria: Any medical contraindication to use of a Mirena® IUD, including: Pregnancy (a pregnancy test is required prior to study entry) Known uterine anomaly that distorts the shape of the uterine cavity Acute pelvic inflammatory disease Postpartum endometritis or endometrial infection Known

2015 Clinical Trials

234. Comparison of Low-dose and High-dose Oxytocin Regimens for Labor Augmentation

, an expected average of 3 days ] Estimated blood loss greater than 500 milliliters after a vaginal delivery or greater than 1000 milliliters after a cesarean delivery Intrapartum chorioamnionitis [ Time Frame: From date of admission to labor and delivery unit to date of delivery ] Fever greater than 100.4 Fahrenheit in the intrapartum period with the initiation of a therapeutic antibiotic regimen in the intrapartum period Postpartum endometritis [ Time Frame: From date of delivery to date of hospital (...) the relationship between dose of oxytocin regimen and length of labor, postpartum hemorrhage, intrauterine infection, umbilical cord gas, neonatal Apgar score <5 at 5 minutes, and need for neonatal intensive care. Condition or disease Intervention/treatment Phase Dystocia Drug: Oxytocin Other: Sodium Chloride 0.9% Phase 4 Detailed Description: This randomized double blind clinical trial of consenting nulliparous women in spontaneous labor who require oxytocin for labor augmentation seeks to determine whether

2015 Clinical Trials

235. STRIPES Study: Study To Reduce Infection Post cEsarean Section

will be blinded to the arm in which they have been assigned. The purpose of this study is to determine if the use of 2% chlorhexidine gluconate cloths prior to cesarean section reduces the rate of surgical site wound infection and/or postpartum endometritis, which is an infection or inflammation of the endometrium (the inner lining of the uterus). Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 930 participants Allocation: Randomized (...) of Medicine at Mount Sinai Information provided by (Responsible Party): Icahn School of Medicine at Mount Sinai Study Details Study Description Go to Brief Summary: The objective of this study is to determine if the use of chlorhexidine gluconate cloths prior to cesarean section reduce the rate of infectious morbidity (i.e. surgical site infections, endometritis). The study will be offered to women who present for a scheduled primary or repeat cesarean section at Mount Sinai Medical Center. The eligible

2015 Clinical Trials

236. Methods of Placental Delivery and the Amount of Blood Loss During Cesarean Section

: Cesarean section (CS) is one of the most commonly performed major abdominal operations in women worldwide and its rate is increasing dramatically every year. Some of the reported short-term morbidities include hemorrhage, postoperative fever and endometritis. The method of delivering the placenta is one procedure that may contribute to an increase or decrease in the morbidity of CS. On an average 0.5-1 liter of blood is lost during CS, many variable techniques have been tried to reduce this blood loss (...) blood loss and greater decrease in postoperative hemoglobin levels and postpartum maternal infectious morbidity but with shorter operative time compared with spontaneous placental separation . In addition, it is known that the blood loss at CS delivery is difficult to estimate, and numerous different methods including serial change in hematocrit (Hct), hemoglobin (Hb) level, visual estimation and the gravimetric method are described. A low, but significant, correlation was found between visually

2015 Clinical Trials

237. Influence of BIIAL Following PPH on Dorsal Clitoral Artery Blood Flow and FSFI

Age-matched healthy puerperal women Exclusion Criteria: Known Diabetes Melitus or cardiovascular disease Known affection disorder before or during pregnancy B-lynch procedure, ligation of uterine or ovarian artery, hysterectomy and salphingooophorectomy following postpartum hemorrhage Known functional sexual disorder before pregnancy Postoperative endometritis or other puerperal infections Postoperative thromboembolic incidence Cessation of breastfeeding in puerperal period Contacts and Locations (...) by (Responsible Party): Baris KAYA, Near East University, Turkey Study Details Study Description Go to Brief Summary: Dorsal clitoral artery Doppler examinations in women with bilateral internal iliac artery ligation due to postpartum hemorrhage (study group) and age-matched healthy puerperal women were performed regularly in the postoperative period, in order to evaluate possible effects of BIIAL on clitoral blood flow. Condition or disease Intervention/treatment Bilateral Iliac Artery Ligation Postpartum

2015 Clinical Trials

238. Intrapartum Rapid GBS Testing in Patients Presenting With Threatened Preterm Labor

year ] vaginal delivery [ Time Frame: up to one and a half year ] Postpartum hemorrhage [ Time Frame: up to one and a half year ] Maternal intrapartum chorioamnionitis [ Time Frame: up to one and a half year ] Maternal postpartum endometritis [ Time Frame: up to one and a half year ] Neonatal respiratory distress [ Time Frame: up to one and half year ] Other Outcome Measures: Neonatal intraventricular hemorrhage [ Time Frame: up to one and half year ] Neonatal pneumonia [ Time Frame: up to one

2015 Clinical Trials

239. Women With Epilepsy: a Pilot Study of PK and PD Anti-epileptic Drug Effects in Levonorgestrel Intrauterine System Users

medications other than AEDs (griseofulvin, rifampin, St. John's Wort, bosentan) Depomedroxyprogesterone acetate within previous six months Congenital or acquired uterine anomaly, including myomas, that distort the uterine cavity Acute pelvic infection or a history pelvic infection without subsequent intrauterine pregnancy Postpartum endometritis or infected abortion in the last three months Genital bleeding of unknown etiology Untreated lower genital tract infection (cervical or vaginal) Acute liver

2015 Clinical Trials

240. Pharmacokinetics of Amlodipine Besylate at Delivery and During Lactation

, endometritis or postpartum hemorrhage Administration of greater than 5 mg of amlodipine in 24 hour period Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its identifier (NCT number): NCT02353806 Locations Layout table for location information United States, Texas Parkland Health (...) Medical Center Collaborator: National Center for Advancing Translational Science (NCATS) Information provided by (Responsible Party): Jamie Morgan, University of Texas Southwestern Medical Center Study Details Study Description Go to Brief Summary: This is a phase IV prospective trial to collect and analyze information about the maternal pharmacokinetics of amlodipine besylate at the time of delivery and during postpartum lactation. The study will also evaluate amlodipine concentrations in the infants

2015 Clinical Trials

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