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Postpartum Endometritis

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241. Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. (PubMed)

pregnancy (RR 0.64; 95% CI 0.47 to 0.88 (one trial, 258 women), but there was no reduction in the subgroup of pregnant women with previous preterm birth without BV during the pregnancy (RR 1.08; 95% CI 0.66 to 1.77 (two trials, 500 women)). A reduction in the risk of postpartum endometritis (RR 0.55; 95% CI 0.33 to 0.92 (one trial, 196 women)) was observed in high-risk pregnant women (women with a history of preterm birth, low birthweight, stillbirth or early perinatal death) and in all women (RR 0.53 (...) except that incomplete outcome data produced high risk of bias in some studies. The quality of the evidence using GRADE was assessed as low for preterm prelabour rupture of membranes, low for preterm delivery, moderate for postpartum endometritis, low for prelabour rupture of membranes, and very low for chorioamnionitis. Intrapartum fever needing treatment with antibiotics was not reported in any of the included studies.Antibiotic prophylaxis did not reduce the risk of preterm prelabour rupture

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2015 Cochrane database of systematic reviews (Online)

242. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. (PubMed)

Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates cesarean deliveries.To (...) determine if cleansing the vagina with an antiseptic solution before a cesarean delivery decreases the risk of maternal infectious morbidities, including endometritis and wound complications.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (10 December 2014).We included randomized and quasi-randomized trials assessing the impact of vaginal cleansing immediately before cesarean delivery with any type of antiseptic solution versus a placebo solution/standard of care on post

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2015 Cochrane database of systematic reviews (Online)

243. 17-hydroxyprogesterone caproate for preterm rupture of the membranes: a multicenter, randomized, double-blind, placebo-controlled trial. (PubMed)

suggested that continuation was futile. The primary outcome was achieved in 3% of the 17OHP-C group and 8% of the placebo group (P = .18). There was no significant between-group difference in the prespecified secondary outcomes, randomization-to-delivery interval (17.1 ± 16.1 vs 17.0 ± 15.8 days, respectively; P = .76) or composite adverse perinatal outcome (63% vs 61%, respectively; P = .93). No significant differences were found in other outcomes, which included rates of chorioamnionitis, postpartum (...) endometritis, cesarean delivery, individual components of the composite outcome, or prolonged neonatal length of stay.Compared with placebo, weekly 17OHP-C injections did not prolong pregnancy or reduce perinatal morbidity in patients with PROM in this trial.Copyright © 2015 Elsevier Inc. All rights reserved.

2015 American Journal of Obstetrics and Gynecology Controlled trial quality: predicted high

244. Timing of Antibiotic Prophylaxis in Elective Caesarean Delivery: A Multi-Center Randomized Controlled Trial and Meta-Analysis. (PubMed)

others received antibiotics after umbilical cords clamping. For the meta-analysis, studies were identified from the database of PUBMED, Cochrane Library and EMbase and assessed using the Cochrane risk of bias tool.Four hundred and ten patients were randomized to receive antibiotics before skin incision (n = 205) or after umbilical cords clamping (n = 205). There was no difference in the incidence of postpartum endometritis (RR = 0.34, 95% CI 0.04 to 3.24), wound infection (RR = 3.06, 95% CI 0.13 (...) to 74.69) and total puerperal morbidity (RR = 1.02, 95% CI 0.47 to 2.22). No increase in the incidence of neonatal sepsis (RR = 0.34, 95% CI 0.04 to 3.24), septic workup (RR = 0.41, 95% CI 0.08 to 2.07), or intermediate NICU admission (RR = 0.73, 95% CI 0.24 to 2.26) was observed. The meta-analysis involving nine RCTs showed that no statistically significant difference was found in terms of the risk of postpartum endometritis (RR = 0.73, 95% CI 0.39, 1.36), wound infection (RR = 0.80, 95%CI 0.55, 1.17

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2015 PloS one Controlled trial quality: predicted high

245. The impact of hospital obstetric volume on maternal outcomes in term, non-low-birthweight pregnancies. (PubMed)

higher rates of postpartum hemorrhage in the lowest-volume rural hospitals (category R1 adjusted odds ratio, 3.06; 95% confidence interval, 1.51-6.23). Rates of chorioamnionitis, endometritis, severe perineal lacerations, and wound infection did not differ between volume categories. Longer lengths of stay were observed after maternal complications (eg, chorioamnionitis) in the lowest-volume hospitals (16.9% prolonged length of stay in category 1 hospitals vs 10.5% in category 4 hospitals; adjusted (...) odds ratio, 1.91; 95% confidence interval, 1.01-3.61).After confounder adjustment, few maternal outcomes differed by hospital obstetric volume. However, elevated odds of postpartum hemorrhage in low-volume rural hospitals raises the possibility that maternal outcomes may differ by hospital volume and geography. Further research is needed on maternal outcomes in hospitals of different obstetric volumes.Copyright © 2015 Elsevier Inc. All rights reserved.

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2014 American Journal of Obstetrics and Gynecology

246. Cervical Ripening in Premature Rupture of Membranes

the most significant maternal and neonatal sequelae associated with PROM and this risk increases with the length of time from ruptured membrane to delivery. Induction of labor has been shown to reduce the rates of chorioamnionitis, endometritis and NICU admissions4. Specifically, induction of labor with prostaglandin agents followed by oxytocin, versus oxytocin alone has been shown to be effective for labor induction resulting in vaginal delivery. Management strategies for PROM have been controversial (...) and an unfavorable cervix is associated with increase rates of vaginal delivery and decreased cesarean section rate compared to induction of labor with oxytocin alone. The investigators aim to determine the incidence of endometritis, and neonatal infection associated with PROM in the current medical environment of antibiotic prophylaxis and antenatal steroid use, taking into account the changes in patient characteristics. Condition or disease Intervention/treatment Phase Pregnancy Premature Rupture of Membranes

2014 Clinical Trials

247. Medico-economic Impact of Screening Atopobium Vaginae and Gardnerella Vaginalis in Molecular Biology by "Point-of-care" During Pregnancy

of endometritis [ Time Frame: 30 months ] the preterm birth rate adjusted [ Time Frame: 30 months ] he total duration of hospitalization and earlier for postpartum mother and newborn in number of days [ Time Frame: 30 months ] 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

2014 Clinical Trials

248. Safety Study of Hyoscine N Butyl Bromide in Active Management of Labor

outcomes [ Time Frame: up to 7 month ] Maternal complications of drug-related side effects (nausea, vomiting, pruritus, rash, mouth establishment, collided), postpartum hemorrhage (more than 500cc), 3th or 4th degree vaginal tears, intrapartum chorioamnionitis (38 ° C higher fever, vaginal temperature increase, uterine tenderness, or Fetal heart rate above 160 to be), postpartum endometritis (first 24 hours, 38 ° C higher with fever uterine tenderness, purulent foul-smelling discharge) covers. Safety (...) - and postpartum haemoglobin levels, birth weight and APGAR scores were recorded. Neonatal APGAR scores were determined 1 and 5 minutes after birth. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 382 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Triple (Participant, Care Provider, Investigator) Primary Purpose: Treatment Official Title: Efficacy and Safety of Hyoscine N Butyl Bromide

2014 Clinical Trials

249. Randomized Control Trial of Second Stage of Labor

Outcome Measures: Operative Vaginal Delivery [ Time Frame: at time of delivery, 4 hours second stage for "Extended" 3 hours second stage for "Usual" ] Spontaneous Vaginal Delivery [ Time Frame: at time of delivery, 4 hours second stage for "Extended" 3 hours second stage for "Usual" ] Endometritis [ Time Frame: at time of delivery until maternal discharge, usually < 5 days ] Clinical diagnosis of postpartum endometritis of the mother Transfusion [ Time Frame: at time of delivery until maternal (...) risk for postpartum hemorrhage, bowel and bladder injury, abnormal placentation, febrile morbidity and death. The most common reason for a cesarean delivery is a repeat cesarean delivery. One way to reduce this number is to prevent the first cesarean delivery. The aim of this study is evaluate if extending the second stage of labor affects the cesarean delivery rate and subsequent perinatal morbidity. Condition or disease Intervention/treatment Phase Labor Complications Other: Length of Second

2014 Clinical Trials

250. Extra-abdominal Removal of Placenta During CS

of the placenta) may decrease the amount of blood flowing into the abdominal cavity during removal of placenta. In this study the investigators aimed to evaluate the influence of intra abdominal vs extra abdominal removal of placenta on duration of operation, the amount of aspirated fluid during the operation, difference between postoperative hemoglobin and hematocrit levels, postoperative pain score, additional need of analgesia, postoperative bowel movements, postoperative endometritis and wound infection (...) 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: 18 Years to 50 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Women undergoing cesarean section according to the obstetrical indications. Exclusion Criteria: Uterine anomalies such as didelphys, bicornis, etc. Placental adhesion anomalies Postpartum

2014 Clinical Trials

251. The Use of Levonorgestrel-Releasing Device (Metraplant-E) in the Treatment of Dysfunctional Uterine Bleeding

who are married or previously married. Failure of other medical treatment to control menorrhagia such as hemostatics. Women who did not tolerate copper IUD due to increased amount of menstrual blood loss which could lead to anemia. Exclusion Criteria: History of ectopic pregnancy . Pregnancy or suspicion of pregnancy. Congenital or acquired uterine anomaly including fibroids if they distort the uterine cavity. Acute pelvic inflammatory disease Postpartum endometritis or infected abortion

2014 Clinical Trials

252. Prevention of Surgical Site Infection After Cesarean Delivery

space/endometritis) will be documented. In addition to inpatient surveillance, the electronic clinic records for all patients will be reviewed, and data will be recorded for any SSI that is diagnosed and treated on an outpatient basis. Documentation from discharge to the six-week postpartum visit will be reviewed to ensure data fidelity, but only infections that occur within 30 days of cesarean delivery will be included in the final analyses. Active SSI will be treated according to prevailing (...) for this study will be any SSI diagnosed within 30 days of cesarean delivery. Our secondary outcomes will be the type of SSI (based on the Center for Disease Control infection classification) and the time to diagnosis of SSI. The Infectious Disease department at BWH will perform the surveillance for SSI/endometritis. This team will be blinded to the choice of anti-sepsis preparation during the study period. Briefly, surveillance will include daily, weekly, monthly, and quarterly reviews of data

2014 Clinical Trials

253. Antibiotics and Gut Microbiota Among Newborn Infants

University of Southern Denmark Information provided by (Responsible Party): Nana Hyldig, Odense University Hospital Study Details Study Description Go to Brief Summary: Background Women undergoing Caesarean Section (CS) have an increased risk of postpartum infections compared to women undergoing vaginal delivery. In Denmark the incidence of post-CS infections is 7-10%. The most common infections are endometritis, Urinary tract infections (UTI) and wound infections (WI). Prophylactic antibiotics (...) , especially for the weakest newborn infants. This pilot study will be a feasibility study to the original study, which examines the effect of change in timing of prophylactic antibiotics on the rate of post-CS infections (endometritis, UTI and WI). The pilot study focus on antibiotic and changes in the gut microbiota of newborn infants. The feasibility study will only include pregnant women in Odense with a body mass index below 30, and planned cesarean section. Condition or disease Intervention/treatment

2014 Clinical Trials

254. Preliminary Study of a Vaginal Lubrication Ring to Treat the Symptoms of Vaginal Dryness

or vaginal injections/lesions or complaints, as well as undiagnosed abnormal genital bleeding History of chronic pelvic pain, interstitial cystitis, vulvar vestibulitis, pelvic inflammatory disease within the past 12 weeks Known current clinically evident cervical or vaginal infection Postpartum or post-abortion endometritis, unless symptoms resolved at least 12 weeks prior to study entry Current persistent, abnormal vaginal bleeding History of inability to place an IVR History of any abnormality

2014 Clinical Trials

255. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. (PubMed)

Different classes of antibiotics given to women routinely for preventing infection at caesarean section. Caesarean section increases the risk of postpartum infection for women and prophylactic antibiotics have been shown to reduce the incidence; however, there are adverse effects. It is important to identify the most effective class of antibiotics to use and those with the least adverse effects.To determine, from the best available evidence, the balance of benefits and harms between different (...) ), we found no significant difference between these classes of antibiotics for our chosen most important seven outcomes namely: maternal sepsis - there were no women with sepsis in the two studies involving 346 women; maternal endometritis (risk ratio (RR) 1.11, 95% confidence interval (CI) 0.81 to 1.52, nine studies, 3130 women, random effects, moderate quality of the evidence); maternal wound infection (RR 0.83, 95% CI 0.38 to 1.81, nine studies, 1497 women, random effects, low quality

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2014 Cochrane database of systematic reviews (Online)

256. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. (PubMed)

Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. The single most important risk factor for postpartum maternal infection is cesarean section. Although guidelines endorse the use of prophylactic antibiotics for women undergoing cesarean section, there is not uniform implementation of this recommendation. This is an update of a Cochrane review first published in 1995 and last updated in 2010.To assess the effects of prophylactic antibiotics compared (...) . The clinically important primary outcomes were wound infection, endometritis, serious maternal infectious complications and adverse effects on the infant. We presented dichotomous data as risk ratios (RR), with 95% confidence intervals (CIs) and combined trials in meta-analyses. We assessed the quality of evidence using the GRADE approach.We identified 95 studies enrolling over 15,000 women. Compared with placebo or no treatment, the use of prophylactic antibiotics in women undergoing cesarean section

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2014 Cochrane database of systematic reviews (Online)

257. Invited review: Systematic review of diagnostic tests for reproductive-tract infection and inflammation in dairy cows. (PubMed)

Invited review: Systematic review of diagnostic tests for reproductive-tract infection and inflammation in dairy cows. The objective of this study was to conduct a systematic and critical appraisal of the quality of previous publications and describe diagnostic methods, diagnostic criteria and definitions, repeatability, and agreement among methods for diagnosis of vaginitis, cervicitis, endometritis, salpingitis, and oophoritis in dairy cows. Publications (n=1,600) that included the words (...) studies are necessary to determine optimal cut points and time postpartum of examination. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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2014 Journal of dairy science

258. Routine cervical dilatation during elective caesarean section. Should we continue? (PubMed)

Routine cervical dilatation during elective caesarean section. Should we continue? The caesarean section rate is on the increase globally, with its attendant complications. One of the measures adopted by obstetricians to decrease complications, such as endometritis and blood loss is intraoperative cervical dilatation during elective caesarean section. A multicentre double blind randomised controlled trial was carried out in Enugu, Nigeria, to ascertain the usefulness of this practice. A total (...) of 208 pregnant women were randomised: 104 had intraoperative cervical dilatation and the other 104 did not have their cervices dilated. All the patients had similar preoperative, intraoperative and postoperative care and were followed up to 6 weeks postpartum. There was no significant difference between the two groups. In conclusion, the study shows no benefit in routine intraoperative cervical dilation. Practitioners must make sure that neither the placenta nor fetal membrane is overlying

2014 Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology Controlled trial quality: uncertain

259. Denaverine hydrochloride and carbetocin increased welfare during and after parturition and enhanced subsequent fertility in cattle. (PubMed)

Denaverine hydrochloride and carbetocin increased welfare during and after parturition and enhanced subsequent fertility in cattle. The objectives of the current study were to investigate the influence of denaverine hydrochloride and carbetocin on softening and dilatation of the birth canal, the need for assistance during parturition, calf mortality, retention of fetal membranes, endometritis, and subsequent fertility. Altogether 200 animals (100 cows and 100 heifers) of the Simmental breed (...) were divided into 2 groups: treatment (n = 100) and control (n = 100). Animals in the treatment group received denaverine hydrochloride and carbetocin (a maximum of twice for each, depending on the progression of labor) during delivery over a maximum of 4 waiting periods (30 min each), whereas control animals experienced the same waiting periods but received no treatment. The treatment protocol had a positive influence on the ease of calving and postpartum reproductive health. The treatment

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2014 Journal of dairy science Controlled trial quality: uncertain

260. Pelvic Inflammatory Disease (Overview)

or postpartum uterus. Genetic factors Genetically mediated variation in immune response plays an important role in susceptibility to PID. [ ] Variants in the genes that regulate toll-like receptors (TLRs), an important component in the innate immune system, have been associated with an increased progression of C trachomatis infection to PID. [ ] Den Hartog et al found a possible contributing role of 5 single-nucleoside polymorphisms (SNPs) in 4 genes encoding pattern recognition receptors in local tubal (...) to vaginal inflammation, which could facilitate ascending infection with BV-associated organisms (eg, G vaginalis ). However evidence is unclear if detecting and treating BV reduces PID related infection. [ ] In some regions, PID may be from a granulomatous salpingitis caused by Mycobacterium tuberculosis or Schistosoma species. [ ] In a cross-sectional study of 736 women with PID, patients with Trichomonas infections demonstrated a 4-fold increase in the histologic evidence of acute endometritis

2014 eMedicine.com

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