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Postpartum Endometritis

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341. 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 Emergency Medicine

342. 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 Emergency Medicine

343. Coccidioidomycosis (Overview)

and in the immediate postpartum period, are at higher risk for dissemination than the general population. [ , , ] All age groups can be affected. Primary infection of the newborn rarely occurs. [ ] Infection of the genital tract of the mother can result in placental involvement, coccidioidal endometritis, and aspiration of infected amniotic fluid by the fetus. Both congenital and perinatal transmission of Coccidioides species have been reported. However, infants can experience severe disease within the first few

2014 eMedicine Emergency Medicine

344. Vaginitis (Diagnosis)

with an increased risk of adverse pregnancy outcomes, including , , preterm delivery, low birth weight, and postpartum endometritis. [ ] Previous Next: Patient Education Safe sex and STD counseling may help decrease the rates of reinfection. Discuss further preventive efforts, including proper hygiene and toilet techniques, when it is appropriate to do so. Remind patients that douching can spread a vaginal or cervical infection into the uterus, increasing the likelihood of PID; douching can also be associated (...) to prevent HIV, bacterial vaginosis and sexually transmitted infections, including trichomoniasis, are considered to be risk factors for HIV. Chronic vaginal infection can facilitate the transmission of various STDs, including HIV. Complications of bacterial vaginosis include endometritis and . Untreated bacterial vaginosis may result in complications (eg, vaginal wound infections) after gynecologic surgical procedures. In pregnancy, Trichomonas infection and bacterial vaginosis are associated

2014 eMedicine Emergency Medicine

345. Ultrasonography, Pelvic (Diagnosis)

evaluation in the emergency department. Emerg Med Clin North Am . 2001 Aug. 19(3):799-816. . Moloney F, Ryan D, Twomey M, Hewitt M, Barry J. Comparison of MRI and high-resolution transvaginal sonography for the local staging of cervical cancer. J Clin Ultrasound . 2016 Feb. 44 (2):78-84. . Dart RG. Role of pelvic ultrasonography in evaluation of symptomatic first-trimester pregnancy. Ann Emerg Med . 1999 Mar. 33(3):310-20. . Lee NK, Kim S, Lee JW, Sol YL, Kim CW, Hyun Sung K, et al. Postpartum hemorrhage (...) : Clinical and radiologic aspects. Eur J Radiol . 2009 May 22. . Brown DL. Pelvic ultrasound in the postabortion and postpartum patient. Ultrasound Q . 2005 Mar. 21(1):27-37. . Matijevic R, Knezevic M, Grgic O, Zlodi-Hrsak L. Diagnostic accuracy of sonographic and clinical parameters in the prediction of retained products of conception. J Ultrasound Med . 2009 Mar. 28(3):295-9. . Wolman I, Altman E, Fait G, Har-Toov J, Gull I, Amster R, et al. Evacuating retained products of conception in the setting

2014 eMedicine Emergency Medicine

346. A Study on the Safety and Efficacy of the SCu300A IUB Compared to the TCu380 Copper IUD

A previously placed IUD that has not been removed Pregnancy or suspicion of pregnancy Use of other contraception method (condom for either male or female, oral contraceptives, diaphragms, spermicides, hormonal patches, injections or ring, cervical cap) History of pelvic inflammatory disease, recent or remote. Postpartum endometritis or post abortal endometritis in the past 3 month Mucopurulent cervicitis Endometrial thickness more than 12 mm on insertion date Known anemia History of previous IUD (...) before adding more. A Study on the Safety and Efficacy of the SCu300A IUB Compared to the TCu380 Copper IUD 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: NCT02036203 Recruitment Status : Withdrawn (The study was withdrawn prior to patients enrolment due to sponsor's decision) First Posted : January 14

2013 Clinical Trials

347. Multivariate Assessment of the IUB Intrauterine Device Compared With a T380A IUD

to fully comply with treatment process Healthy women seeking LARC Married or in a steady relationship (at least 1 year) Blood hemoglobin >11.5gr/dL Signed informed consent form If took COCP at least had one cycle after use of OC Exclusion criteria: Use IUB/IUD as an emergency contraception A previously placed IUD that has not been removed Pregnancy or suspicion of pregnancy Immediately post-abortion or post-partum - unless had at least one free cycle Use of other contraception method (condom for either (...) male or female, oral contraceptives, diaphragms, spermicides, hormonal patches, injections or ring, cervical cap) History of pelvic inflammatory disease, recent or remote. Postpartum endometritis or postabortal endometritis in the past 3 month Mucupurulent cervicitis Endometrial thickness more than 12 mm on insertion date Known anemia (except thalassemia, sickle cell, chronic anemia) Severe Mennorrhagia or severe Dysmenorrhea History of previous IUD complications Dysfunctional uterine bleeding

2013 Clinical Trials

348. A Randomized Trial of Induction Versus Expectant Management

: During labor and delivery ] Labor pain was scored according to a 10-point Likert scale, with higher scores indicating greater pain; included are women who had spontaneous labor, labor that started spontaneously but then was augmented, or induced labor. Number of Participants With Maternal Postpartum Infection [ Time Frame: delivery through discharge ] Defined as any of the following: Clinical diagnosis of endometritis Wound reopened for hematoma, seroma, infection or other reasons Cellulitis (...) Expectant Management (ARRIVE) 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: NCT01990612 Recruitment Status : Completed First Posted : November 21, 2013 Results First Posted : January 25, 2019 Last Update Posted : February 21, 2019 Sponsor: The George Washington University Biostatistics Center Collaborator

2013 Clinical Trials

349. RCT of Postoperative Infections Following Caesarean Section Infections Following Caesarean Section

, 2015 Sponsor: Odense University Hospital Collaborators: Region of Southern Denmark University of Southern Denmark Hvidovre University Hospital Hospital of South West Jutland 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 (...) will examine the effect of change in timing of prophylactic antibiotics on the rate of post-CS infections (endometritis, UTI and WI). The study will be performed at the obstetric departments at Odense University Hospital (OUH), Hvidovre Hospital (HH) and Hospital South West Jutland (HSWJ) in collaboration with the Department of Clinical Microbiology, OUH, to ensure that the most appropriate antibiotic regime is used. Furthermore, collaboration with a neonatologist will ensure appropriate assessment

2013 Clinical Trials

350. A Single Arm Clinical Study of the Safety and Efficacy of the AURORAâ„¢ Endometrial Ablation System

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 participating or considers future participation in any other research of an investigational drug or device. 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 (...) one or more studies before adding more. A 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: NCT02023801 Recruitment Status : Completed First Posted : December 30, 2013 Results First Posted : November 5, 2015

2013 Clinical Trials

351. Monitoring With Ultrasound Imaging of Intrauterine Device (IUD) Position Placed Immediately After Giving Birth

Last Update Posted : October 11, 2017 Sponsor: Icahn School of Medicine at Mount Sinai Collaborator: Teva Pharmaceuticals USA Information provided by (Responsible Party): Icahn School of Medicine at Mount Sinai Study Details Study Description Go to Brief Summary: Intrauterine devices (IUDs) are one of the most effective reversible forms of contraception, and are a good option in the postpartum period for women to avoid a rapid repeat pregnancy. IUDs can be placed immediately postpartum, after (...) IUD or levonorgestrel IUD Exclusion Criteria: Contraindications for IUD use (CDC MEDICAL Eligibility Criteria category 3 or 4 for specific IUD) Positive Chlamydia or gonorrhea cervical cultures in past 3 months Immediate postpartum hemorrhage Premature rupture of membranes (PROM) >12h or diagnosis of endometritis 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

2013 Clinical Trials

352. Is Routine Cervical Dilatation Necessary During Elective Caesarean Section? A Randomised Controlled Trial

dilated after surgery The surgeon inserted his or her double-gloved index digit in the cervical canal to dilate it and removed the outer gloves after digital dilatation of the cervix. Procedure: control group surgeon not dilated cervix after surgery No Intervention: control group cervix not dilated after surgery Outcome Measures Go to Primary Outcome Measures : The primary outcome was rate of post-partum endometritis [ Time Frame: All patients in both groups were observed daily,blood count (...) was assessed 24 h after delivery and the patients were discharged on third postoperative day if there was no infection or complication ] The post-partum care for both groups was identical, and included vital signs every four hours, discontinuation of the Foley catheter and advancement of diet on the first postoperative day. All patients in both groups were observed daily in order to assess the following variables: any sign of wound infection (erythema, swelling, discharge or tenderness), vaginal discharge

2013 Clinical Trials

353. Foley OR MisO for the Management of Induction

to delivery. Maternal and neonatal morbidity with prolonged labor The adverse maternal and neonatal morbidity association with prolonged labor has been demonstrated in numerous studies. An increase in maternal risk of post partum hemorrhage and endometritis has been associated with prolonged labor. Cheng et al demonstrated that the risk of post partum hemorrhage and endometritis significantly increased with increasing length of labor. Maghoma et al evaluated the latent phase of labor and found a similar (...) 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: NCT01916681 Recruitment Status : Completed First Posted : August 6, 2013 Results First Posted : December 21, 2016 Last Update Posted : May 18, 2017 Sponsor: University of Pennsylvania Information provided by (Responsible Party): University of Pennsylvania Study Details Study

2013 Clinical Trials

354. Ultrasound Measure of the Thickness of the Lower Segment in Women Having a History of Caesarian

Intervention/treatment Experimental: Lower Uterine Segment Ultrasound Measure of Uterine Segment by Ultrasound Other: Ultrasound Measure of Uterine Segment by Ultrasound No Intervention: control no measure of Uterine Segment Ultrasound Outcome Measures Go to Primary Outcome Measures : Composite criterion including maternal and neonatal parameters [ Time Frame: at 3 days post partum ] rupture uterine, uterine dehiscence, hysterectomy, deep venous thromboembolic complications, transfusion, endometritis (...) Frame: at 3 days post partum ] Maternal morbidity Hysterectomy [ Time Frame: at 3 days post partum ] Maternal morbidity Transfusion [ Time Frame: at 3 days post partum ] Maternal morbidity Endometritis [ Time Frame: at 3 days post partum ] Maternal morbidity Rate of elective caesarean sections and of caesarean sections during labor [ Time Frame: at 1 day post partum ] Perineal tears of the 3rd and 4th degree [ Time Frame: at 1 day post partum ] Eligibility Criteria Go to Information from

2013 Clinical Trials

355. Plasma concentrations of PGFM and uterine and ovarian responses in early lactation dairy cows fed omega-3 and omega-6 fatty acids. (Abstract)

soybeans (S), and they were fed from calving to Day 70 postpartum. Estrous cycles were synchronized and ovarian follicular development was monitored daily for an entire cycle. There were no differences among diets in the incidence of lameness, mastitis, or metritis, but the incidence of clinical endometritis was lower (P < 0.05) in cows fed S (0%) compared with cows fed C (28.2%) and L (20.5%). Uterine involution in cows fed S occurred 3.77 and 2.78 days earlier, respectively, than in those fed C and L

2013 Theriogenology Controlled trial quality: uncertain

356. Clinical trial of treatment programs for purulent vaginal discharge in lactating dairy cattle in New Zealand. (Abstract)

Clinical trial of treatment programs for purulent vaginal discharge in lactating dairy cattle in New Zealand. Studies of treatment of postpartum endometritis in dairy cows indicate that prostaglandin (PGF2α) might result in similar outcomes as intrauterine antibiotics, but the effect might depend on the presence of a CL. The objective was to compare reproductive performance in cows with purulent vaginal discharge treated on the basis of having or not having a CL (CL-dependent treatment; CLdep

2013 Theriogenology Controlled trial quality: uncertain

357. Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial. Full Text available with Trip Pro

Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial. The purpose was to determine the effect of the timing of prophylactic antibiotics for cesarean section on post-operative infectious complications.This was a prospective, double-blinded, randomized controlled trial in which patients were randomized to receive cefazolin or clindamycin either before skin incision or after cord clamp. The primary outcome was maternal infectious morbidity at 6 weeks postpartum (...) , a composite infectious outcome, which included endometritis, urinary tract infection, wound infection and pneumonia.Data on 896 women were analyzed; 449 randomized to skin incision, 447 to cord clamp. Postpartum infections were seen in a total of 8.4% of patients. Timing of antibiotic administration did not significantly affect any maternal postpartum infection rates or selected neonatal outcomes.Our results suggest that, in a largely non-laboring population, the timing of prophylactic antibiotic

2013 Journal of perinatology : official journal of the California Perinatal Association Controlled trial quality: predicted high

358. Perioperative oxygen supplementation and surgical site infection after cesarean delivery: a randomized trial. (Abstract)

of oxygen used. Patients were evaluated for wound infection or endometritis during their hospital stay and by 6 weeks postpartum. The primary end point was a composite of either surgical site infection or endometritis.Eight hundred thirty-one patients were recruited. Of these, 415 participants received 30% oxygen perioperatively and 416 received 80% oxygen. The groups were well matched for age, race, parity, diabetes, number of previous cesarean deliveries, and scheduled compared with unscheduled (...) cesarean deliveries. An intention-to-treat analysis was used. There was no difference in the primary composite outcome (8.2% in women who received 30% oxygen compared with 8.2% in women who received 80% oxygen, P=.89), no difference in surgical site infection in the two groups (5.5% compared with 5.8%, P=.98), and no significant difference in endometritis in the two groups (2.7% compared with 2.4%, P=.66), respectively.Women who received 80% supplemental oxygen perioperatively did not have a lower rate

2013 Obstetrics and Gynecology Controlled trial quality: predicted high

359. Effect of an injectable trace mineral supplement containing selenium, copper, zinc, and manganese on the health and production of lactating Holstein cows. (Abstract)

Effect of an injectable trace mineral supplement containing selenium, copper, zinc, and manganese on the health and production of lactating Holstein cows. The objective of this study was to evaluate the effect of a subcutaneous injection of a multimineral preparation containing 300 mg of zinc, 50mg of manganese, 25mg of selenium, and 75 mg of copper at 230 and 260 days of gestation and 35 days postpartum, on the health, milk production and reproductive performance of lactating Holstein cows (...) ); for multiparous cows, the incidence of clinical mastitis for control and TMS cows was 25.4% and 19.7%, respectively (P=0.03). Additionally, control cows had increased odds of stillbirth and endometritis (odds ratios 1.69 and 1.30, respectively). The incidence of endometritis was 34.2% and 28.6% for control and TMS cows, respectively (P=0.039) but treatment had no effect on reproductive performance, milk production or other health traits. Further research is required to confirm these findings and to establish

2013 Veterinary journal (London, England : 1997) Controlled trial quality: uncertain

360. Effects of ecbolic agents on measurements of uterine involution in the mare. (Abstract)

post partum for subjective assessment of endometritis and morphometric analysis of endometrial histoarchitecture. Mean values for all measurements of uterine involution did not differ among groups (P>0.05). For all mares, the diameter of luminal fluid was not correlated to diameter of the uterine body or uterine horns, or to morphometric measurements of endometrial histoarchitecture of the previously gravid uterine horn (P>0.05). Likewise, accumulation of fluid within the uterine lumen (...) Effects of ecbolic agents on measurements of uterine involution in the mare. Thirteen postparturient mares were used to investigate the effects of ecbolic agents on the rate of uterine involution. Mares were randomly assigned to one of three treatment groups: Group S = intravenous injection of 2 ml saline twice daily for 10 days post partum (n=4); Group O = intravenous injection of 20 units oxytocin twice daily for 10 days post partum (n=4); and Group P = intramuscular injection of 500 mcg

2012 Theriogenology Controlled trial quality: uncertain

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