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Postpartum Endometritis

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261. Cervical Ripening in Premature Rupture of Membranes

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02314728 Recruitment Status : Unknown Verified March 2016 by Montefiore Medical Center. Recruitment status was: Recruiting First Posted : December 11, 2014 Last Update Posted : March 17, 2016 Sponsor: Montefiore Medical Center Information provided (...) 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

2014 Clinical Trials

262. 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 (...) Identifier: NCT02288832 Recruitment Status : Completed First Posted : November 11, 2014 Last Update Posted : September 3, 2018 Sponsor: Assistance Publique Hopitaux De Marseille Information provided by (Responsible Party): Assistance Publique Hopitaux De Marseille Study Details Study Description Go to Brief Summary: Infection is the principal cause of preterm births. Most (90%) women with preterm deliveries have no abnormal history. It is widely agreed that preterm delivery is often associated

2014 Clinical Trials

263. 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 (...) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02101515 Recruitment Status : Completed First Posted : April 2, 2014 Results First Posted : October 26, 2018 Last Update Posted : October 26, 2018 Sponsor: Thomas Jefferson University Information provided by (Responsible Party): alexis gimovsky, Thomas

2014 Clinical Trials

264. Extra-abdominal Removal of Placenta During CS

and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02101450 Recruitment Status : Completed First Posted : April 2, 2014 Last Update Posted : January 13, 2015 Sponsor: Near East University, Turkey Information provided by (Responsible Party): Baris KAYA, Near East University, Turkey Study Details Study Description Go (...) 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

2014 Clinical Trials

265. 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 (...) of Hyoscine N Butyl Bromide in Active Management of Labor (HBB) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02098889 Recruitment Status : Completed First Posted : March 28, 2014 Last Update Posted : March 28, 2014 Sponsor: Sisli Hamidiye Etfal Training and Research Hospital Information provided

2014 Clinical Trials

266. 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 (...) Infection After Cesarean Delivery (CAPISSI) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02027324 Recruitment Status : Withdrawn (Another study with similar methods was recently published) First Posted : January 6, 2014 Last Update Posted : January 12, 2016 Sponsor: Brigham and Women's Hospital

2014 Clinical Trials

267. 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

268. 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 (...) before adding more. Preliminary Study of a Vaginal Lubrication Ring to Treat the Symptoms of Vaginal Dryness The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02029053 Recruitment Status : Completed First Posted : January 7, 2014 Last Update Posted : December 15, 2015 Sponsor: J3 Bioscience, Inc

2014 Clinical Trials

269. A Multi-Center, Single Arm Clinical Study of the Safety and Efficacy of the AURORAâ„¢ Endometrial Ablation System

) which the patient is unwilling to have removed at the time of the operative visit Presence of an implantable contraceptive device (e.g. Essure or Adiana). Subject currently on hormonal birth control therapy or unwilling to use a non-hormonal birth control post-ablation (including a Mirena device). Subject who is within 6-weeks post partum. Any general health condition which, in the opinion of the Investigator, could represent an increased risk for the subject Any subject who is currently (...) studies (100). Please remove one or more studies before adding more. A Multi-Center, Single Arm Clinical Study of the Safety and Efficacy of the AURORA™ Endometrial Ablation System The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02029911 Recruitment Status : Completed First Posted : January 8, 2014

2014 Clinical Trials

270. Routine cervical dilatation during elective caesarean section. Should we continue? (Abstract)

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

271. The impact of hospital obstetric volume on maternal outcomes in term, non-low-birthweight pregnancies. Full Text available with Trip Pro

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.

2014 American Journal of Obstetrics and Gynecology

272. Postterm Pregnancy (Treatment)

’ gestation). [ ] Maternal risks and mode of delivery The maternal risks of postterm pregnancy are often underappreciated. These include an increase in (9-12% vs 2-7% at term), an increase in severe perineal injury (3 rd and 4 th degree perineal lacerations) related to macrosomia (3.3% vs 2.6% at term) and operative vaginal delivery, and a doubling in the rate of cesarean delivery (14% vs 7% at term). [ , , , ] The latter is associated with higher risks of complications such as endometritis, hemorrhage (...) in term pregnancies prior to 42 weeks of gestation. Such complications as chorioamnionitis, severe perineal lacerations, cesarean delivery rates, postpartum hemorrhage, and endomyometritis all increase progressively after 39 weeks of gestation. [ , , , , ] Next: Timing of Delivery The first decision that must be made when managing an impending postterm pregnancy is whether to deliver. In certain cases (eg, nonreassuring surveillance, oligohydramnios, growth restriction, certain maternal diseases

2014 eMedicine.com

273. Placenta Previa (Overview)

in cases of placenta previa as well as placenta accreta, increta, and percreta.) Higher rates of blood transfusion [ , ] Placental abruption Preterm delivery Increased incidence of postpartum endometritis [ ] Mortality rate (2-3%); in the US, the maternal mortality rate is 0.03%, the great majority of which is related to uterine bleeding and the complication of The Table, below, summarizes the relative risk of some morbidities in women with placenta previa. Table. Relative Risk of Morbidities (...) birth is highly associated with placenta previa, with 16.9% of women delivering at less than 34 weeks and 27.5% delivering between 34 and 37 weeks in a population-based study from 1989 to 1997. [ ] There is a significant increase in the risk of postpartum hemorrhage and need for emergency hysterectomy in women with placenta previa. [ ] Maternal complications of placenta previa are summarized as follows: Hemorrhage, [ ] including rebleeding (Planning delivery and control of hemorrhage is critical

2014 eMedicine.com

274. Premature Rupture of Membranes (Overview)

and fetus, they are both determined to be clinically stable, expectant management of PPROM may be considered to improve fetal outcome. The primary maternal risk with expectant management of PPROM is infection. This includes chorioamnionitis (13-60%), endometritis (2-13%), sepsis (< 1%), and maternal death (1-2 cases per 1000). Complications related to the placenta include abruption (4-12%) and retained placenta or postpartum hemorrhage requiring uterine curettage (12%). [ ] The risks and potential (...) expectant management for as many as 4 days with induction of labor for complications. [ ] They concluded that, in women with PROM, induction of labor and expectant management resulted in similar rates of cesarean delivery and neonatal infection. However, induction with oxytocin resulted in a lower risk of maternal infection (endometritis) when compared with expectant management. Additionally, the women in the study viewed induction of labor more favorably than expectant management. Other smaller studies

2014 eMedicine.com

275. Postterm Pregnancy (Overview)

’ gestation). [ ] Maternal risks and mode of delivery The maternal risks of postterm pregnancy are often underappreciated. These include an increase in (9-12% vs 2-7% at term), an increase in severe perineal injury (3 rd and 4 th degree perineal lacerations) related to macrosomia (3.3% vs 2.6% at term) and operative vaginal delivery, and a doubling in the rate of cesarean delivery (14% vs 7% at term). [ , , , ] The latter is associated with higher risks of complications such as endometritis, hemorrhage (...) in term pregnancies prior to 42 weeks of gestation. Such complications as chorioamnionitis, severe perineal lacerations, cesarean delivery rates, postpartum hemorrhage, and endomyometritis all increase progressively after 39 weeks of gestation. [ , , , , ] Next: Timing of Delivery The first decision that must be made when managing an impending postterm pregnancy is whether to deliver. In certain cases (eg, nonreassuring surveillance, oligohydramnios, growth restriction, certain maternal diseases

2014 eMedicine.com

276. Premature Rupture of Membranes (Treatment)

and fetus, they are both determined to be clinically stable, expectant management of PPROM may be considered to improve fetal outcome. The primary maternal risk with expectant management of PPROM is infection. This includes chorioamnionitis (13-60%), endometritis (2-13%), sepsis (< 1%), and maternal death (1-2 cases per 1000). Complications related to the placenta include abruption (4-12%) and retained placenta or postpartum hemorrhage requiring uterine curettage (12%). [ ] The risks and potential (...) expectant management for as many as 4 days with induction of labor for complications. [ ] They concluded that, in women with PROM, induction of labor and expectant management resulted in similar rates of cesarean delivery and neonatal infection. However, induction with oxytocin resulted in a lower risk of maternal infection (endometritis) when compared with expectant management. Additionally, the women in the study viewed induction of labor more favorably than expectant management. Other smaller studies

2014 eMedicine.com

277. 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 (...) genitalium [ , ] Ureaplasma urealyticum Herpes simplex virus 2 (HSV-2) Trichomonas vaginalis (CMV) Haemophilus influenzae Streptococcus agalactiae Enteric gram-negative rods (eg, Escherichia coli ) Enterococcus, described in 2 individuals post IUD insertion [ ] Peptococcus species Anaerobes The microbiology of PID reflects the predominant sexually transmitted pathogens within a specific population, as well as some organisms less commonly seen in that population. Bacterial vaginosis (BV) may lead

2014 eMedicine.com

278. Oophoritis (Overview)

-related factors PID rarely occurs in pregnancy; however, chorioamnionitis can occur in the first 12 weeks of gestation, before the mucous plug solidifies and seals off the uterus from ascending bacteria. Fetal loss may result. Concurrent pregnancy influences the choice of antibiotic therapy for PID and demands that an alternative diagnosis of ectopic pregnancy be excluded. Uterine infection is usually limited to the endometrium but may be more invasive in a gravid or postpartum uterus. Genetic factors (...) (HSV-2) Trichomonas vaginalis (CMV) Haemophilus influenzae Streptococcus agalactiae Enteric gram-negative rods (eg, Escherichia coli ) Enterococcus, described in 2 individuals post IUD insertion [ ] Peptococcus species Anaerobes The microbiology of PID reflects the predominant sexually transmitted pathogens within a specific population, as well as some organisms less commonly seen in that population. Bacterial vaginosis (BV) may lead to vaginal inflammation, which could facilitate ascending

2014 eMedicine.com

279. Gardnerella (Overview)

. Uncomplicated bacterial vaginosis that is assessed promptly typically resolves with standard antibiotic treatment. The prognosis for complicated cases of bacterial vaginosis leading to other infections varies depending on the particular infectious process. Note the following: Long-standing or untreated BV may lead to more serious sequelae, such as , , , or complications of pregnancy, including , premature labor, chorioamnionitis, and postpartum endometritis. BV leads to an increased risk for acquiring HIV (...) , postsurgical infections (eg, postcesarean endometritis, posthysterectomy vaginal cuff cellulitis), and adverse outcomes in pregnancy, including premature rupture of membranes, premature labor, chorioamnionitis, and postpartum endometritis. Mixed infections Mixed infections with Trichomonas and yeast can occur among patients with BV. Bacteremia Gardnerella vaginalis bacteremia occurs much more commonly in women than in men and occurs most commonly in postpartum and postgynecologic procedure infections (eg

2014 eMedicine.com

280. Fallopian Tube Reconstruction (Overview)

a tubal sterilization reversal procedure delivered live children. The menstrual history is essential to evaluate a possible ovulatory factor. The obstetrical history establishes whether the woman has ever been able to conceive and whether she has had any pregnancy complications, such as an ectopic pregnancy or postpartum endometritis, that may have compromised her reproductive tract. The gynecological history reveals possible problems with the reproductive organs that may affect fertility (...) possible causes of ovulatory dysfunction secondary to hypothalamic/pituitary disorders or intrinsic ovarian malfunction. A history of PID, endometritis, and other causes of pelvic inflammation, such as endometriosis or appendicitis, should be elicited. Correctible medical contraindications to pregnancy (and surgery), such as uncontrolled diabetes, hypertension, or cardiac or renal disease, should be excluded or corrected. The surgical history should focus on the pelvis because any surgery

2014 eMedicine.com

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