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Postpartum Endometritis

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501. Epidemiology of and surveillance for postpartum infections. Full Text available with Trip Pro

% following vaginal delivery. Rehospitalization; cesarean delivery; antistaphylococcal antibiotics; diagnosis codes for mastitis, endometritis, and wound infection; and ambulatory blood or wound cultures were important predictors of infection. Use of automated information routinely collected by HMOs and insurers allows efficient identification of postpartum infections not detected by conventional surveillance. (...) Epidemiology of and surveillance for postpartum infections. We screened automated ambulatory medical records, hospital and emergency room claims, and pharmacy records of 2,826 health maintenance organization (HMO) members who gave birth over a 30-month period. Full-text ambulatory records were reviewed for the 30-day postpartum period to confirm infection status for a weighted sample of cases. The overall postpartum infection rate was 6.0%, with rates of 7.4% following cesarean section and 5.5

2001 Emerging Infectious Diseases

502. [Effect of a 10 day postpartum administration of a PGF2 alpha analog at different concentrations on the course of the puerperium and fertility in dairy cows]. (Abstract)

[Effect of a 10 day postpartum administration of a PGF2 alpha analog at different concentrations on the course of the puerperium and fertility in dairy cows]. In this double-blind Study 72 dairy cows were treated with injections of Luprostiol (Reprodin). 32 cows served as control. Gynaecological examinations in 10-day intervals up to day 40 post partum and determination of progesterone levels in milk samples taken in 3-day intervals up to day 73 p. p. were performed. The administration of PGF2 (...) in the placebo group up to day 20 p. p. Until day 40 p. p. the cervical diameters of the probands equaled those of the control animals. In contrary to cows after uncomplicated delivery the injection of PGF2 alpha after complicated parturition lead to a significant (p < 0.05) reduction of puerperal endometritis. Neither in cows with uncomplicated nor complicated delivery the administration of PGF2 alpha resulted in an improved conception rate. There were no significant positive effects on fertility parameters

1999 Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere Controlled trial quality: uncertain

503. Placenta accreta postpartum. (Abstract)

Placenta accreta postpartum. Placenta accreta is the abnormal attachment of the placenta to the uterus. It occurs when the decidua basalis is either absent or incomplete. It is uncommon and most often presents with a retained placenta and hemorrhage.A 29-year-old gravida 1 had an uncomplicated antenatal course and delivery. The third stage of labor was complicated by a retained placenta necessitating manual removal. Her postpartum course was complicated by a persistent endometritis (...) . The diagnosis of placenta accreta was made with the help of sonohysterography.Sonohysterography is a useful tool in discriminating a solid intracavitary mass from a placenta accreta postpartum.

2002 Obstetrics and Gynecology

504. Influence of various treatment methods on bacteriological findings in cows with puerperal endometritis. (Abstract)

Influence of various treatment methods on bacteriological findings in cows with puerperal endometritis. The aim of the study was to identify the species of microorganisms isolated from the uterus of healthy cows (control group) and cows affected with puerperal metritis (PM) before and after an experimental therapy with an immunomodulator and antibiotics versus commonly applied methods (antibiotic + beta-blocker or antibiotic + PGF2alpha). Examinations were carried out on 110 cows with PM (...) in three farms with similar system of rearing and nutrition. The control group consisted of 21 cows without postpartum disturbances. Smears from the uterus were taken before treatment and then at 21st day of observation. Escherichia coli and other species of Enterobacteriaceae family were isolated from 48.2% of PM cows and 47.6% of healthy cows. The degree of Arcanobacterium pyogenes infection was statistically lower in healthy than in sick cows (9.5% versus 30.0%). Streptococcus sp. was isolated from

2004 Polish journal of veterinary sciences Controlled trial quality: uncertain

505. [Treatment of chronic bovine endometritis and factors for treatment success]. (Abstract)

[Treatment of chronic bovine endometritis and factors for treatment success]. In a controlled field trial, 178 dairy cows with chronic endometritis and at least 21 days in lactation were randomly assigned to four different treatment groups: prostaglandin F2alpha intramuscularly (PG, 5 mg dinoprost (5 ml Dinolytic), n = 51), intrauterine antibiotics (AB; 400 mg ampicillin + 800 oxacillin (20 ml Totocillin), n = 49), intrauterine antiseptics (AS; 100 ml 4% Lotagen, n = 50); control (C, no initial (...) . Therefore, factors that might have an influence on clinical cure and fertility were evaluated. With increasing duration of lactation, the clinical cure after a single treatment increased significantly over all treatment groups from 59.5% (treatment before day 42 postpartum) to 79.6% (treatment following day 42 postpartum) (P < 0.05). Within the PG group, a statistically significantly higher cure rate after a single treatment and first service conception rate and a lower pregnancy index were obtained

2005 DTW. Deutsche tierärztliche Wochenschrift Controlled trial quality: uncertain

506. The effect of placental removal method and site of uterine repair on postcesarean endometritis and operative blood loss. (Abstract)

The effect of placental removal method and site of uterine repair on postcesarean endometritis and operative blood loss. Our purpose was to determine whether blood loss during cesarean section and postoperative endometritis rate were associated with the method of placental removal and site of uterine repair.This prospective randomized study involved 840 women who underwent cesarean section. The patients were grouped into four: (1) manual placental delivery + exteriorized uterine repair; (2 (...) ) spontaneous placental delivery + exteriorized uterine repair; (3) manual placental delivery + in situ uterine repair; (4) spontaneous placental delivery + in situ uterine repair. Patients were excluded if they had received intrapartum antibiotics, had chorioamnionitis, required an emergency cesarean hysterectomy, had rupture of membranes for more than 12 hr, had bleeding diathesis, and had abnormal placentation or prior postpartum hemorrhage. The main outcome measures were postoperative hemoglobin

2005 Acta Obstetricia et Gynecologica Scandinavica Controlled trial quality: uncertain

507. Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery. (Abstract)

Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery. This study was undertaken to determine whether endometrial microbial colonization or plasma cell endometritis is increased after spontaneous versus indicated preterm delivery or a spontaneous term delivery.Postpartum, endometrial specimens were obtained after a spontaneous (mean 83, +/- 17.6 days) or indicated (mean 83, +/- 16.7 days) preterm delivery before 34 weeks (...) ' gestation and after a spontaneous term delivery (mean 82, +/- 15.7 days; P=.980). Cultures for aerobic and anaerobic bacteria, Trichomonas vaginalis, and genital mycoplasmas were performed. Histologic endometritis was defined as the presence of plasma cells.The study population (n=820) was 71% black, 29% white, 69% unmarried, and 31% had less than 12 years of education. Endometrial cultures were positive for at least 1 microorganism in 82% of the women. No significant difference in positive endometrial

2005 American Journal of Obstetrics and Gynecology

508. A comparison of once-daily and 8-hour gentamicin dosing in the treatment of postpartum endometritis

A comparison of once-daily and 8-hour gentamicin dosing in the treatment of postpartum endometritis A comparison of once-daily and 8-hour gentamicin dosing in the treatment of postpartum endometritis A comparison of once-daily and 8-hour gentamicin dosing in the treatment of postpartum endometritis Del Priore G, Jackson-Stone M, Shim E K, Garfinkel J, Eichmann M A, Frederiksen M C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS (...) EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Using gentamicin once-daily doses in patients with postpartum endometritis. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Postpartum women with endometritis diagnosed on clinical finding of fever (either two oral temperatures greater than 38C

1996 NHS Economic Evaluation Database.

509. Endometritis

Endometritis Postpartum Endometritis. About Postpartum Endometritis | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Postpartum Endometritis Authored by , Reviewed by | Last edited 24 Feb 2017 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) Guidelines. You may find the article more useful, or one of our other . In this article In This Article Postpartum Endometritis In this article Definition Endometritis refers to infection or inflammation of the endometrium, the inner lining of the uterus. It can be divided into pregnancy-related (obstetric) or non-obstetric. Pathologically, it can be described as acute and chronic: Acute endometritis is characterised by the presence of more than five neutrophils in a 400 power field in the endometrial

2008 Mentor

510. Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis. (Abstract)

Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis. One hundred fifty-two women who received cefazolin prophylaxis and subsequently developed postpartum endometritis were randomized to treatment with either ticarcillin/clavulanic acid (75) or clindamycin-gentamicin (77). Bacteria isolated from the endometrium were predominantly facultative anaerobic bacteria. The ratio of facultative anaerobes to obligate

1989 Obstetrics and Gynecology Controlled trial quality: uncertain

511. Sulbactam/ampicillin versus metronidazole/gentamicin in the treatment of post-cesarean section endometritis. (Abstract)

Sulbactam/ampicillin versus metronidazole/gentamicin in the treatment of post-cesarean section endometritis. Sixty-seven patients diagnosed with post-cesarean-section endometritis were studied in a prospective comparative randomized trial of sulbactam/ampicillin, a new beta-lactamase inhibitor drug combination, versus treatment with metronidazole/gentamicin. The success rate was 91% for each antibiotic regimen. Mycoplasma spp. or Ureaplasma spp. were isolated from all treatment failures (...) . Endometrial cultures revealed 2.3 aerobes as well as anaerobes per patient, with Enterococcus faecalis, Bacteroides bivius, and Escherichia coli the most frequently reported bacterial isolates in 64, 40, and 28% of all patients, respectively. Positive blood cultures were noted in 11 (15%) patients with Mycoplasma sp. the most commonly found isolate (45.5%). Sulbactam/ampicillin appears to be safe and equally effective as a metronidazole/aminoglycoside drug regimen in the treatment of postpartum

1990 Diagnostic microbiology and infectious disease Controlled trial quality: uncertain

512. Randomized comparison of ampicillin-sulbactam to cefoxitin and doxycycline or clindamycin and gentamicin in the treatment of pelvic inflammatory disease or endometritis. (Abstract)

Randomized comparison of ampicillin-sulbactam to cefoxitin and doxycycline or clindamycin and gentamicin in the treatment of pelvic inflammatory disease or endometritis. To evaluate the efficacy and safety of ampicillin-sulbactam (3 g every 6 hours) in patients with pelvic inflammatory disease or postpartum endometritis using a randomized, comparative, multicenter study of parallel design.Eligible patients with pelvic inflammatory disease were randomized to receive either ampicillin-sulbactam (...) or cefoxitin (2 g every 6 hours) plus doxycycline (100 mg every 12 hours). Those with endometritis were randomized to ampicillin-sulbactam or clindamycin (900 mg every 8 hours) plus gentamicin (1.5 mg/kg every 8 hours). In the ampicillin-sulbactam group, chlamydia-positive patients also received oral doxycycline.For pelvic inflammatory disease, the clinical response rates (cure or improvement) were 85.5% (47 of 55) and 89.6% (43 of 48) in the ampicillin-sulbactam and cefoxitin and doxycycline groups

1994 Obstetrics and Gynecology Controlled trial quality: uncertain

513. Group A streptococcal endometritis: Report of an outbreak and review of the literature Full Text available with Trip Pro

Group A streptococcal endometritis: Report of an outbreak and review of the literature Two cases of group A streptococcus (gas) postpartum endometritis were diagnosed within 24 h following uncomplicated vaginal delivery. Investigation by the infection control service identified all 10 obstetric personnel who performed any invasive procedure on both cases. These personnel were questioned about a recent history of sore throat, skin lesions, vaginal or rectal symptoms. Throat and rectal cultures (...) were obtained for gas from all 10 personnel. A carrier was identified among the personnel screened. This nurse was removed from direct patient care and treated with a two-week course of oral clindamycin and rifampin with documentation of carrier eradication of gas at the end of therapy, 30 days, 60 days and six months post-treatment. All three isolated strains were identical by restriction endonuclease analysis and by M and T typing. Rapid implementation of infection control measures were

1994 The Canadian Journal of Infectious Diseases

514. The effect of treatment of clinical endometritis on reproductive performance in dairy cows. Full Text available with Trip Pro

the effect of treatment on time to pregnancy. There was no benefit of treatment of endometritis before 4 wk postpartum. Administration of PGF2 alpha between 20 and 26 DIM to cows with endometritis that did not have a palpable corpus luteum was associated with a significant reduction in pregnancy rate. Between 27 and 33 DIM, cows with endometritis treated with cephapirin i.u. had a significantly shorter time to pregnancy than untreated cows (hazard ratio = 1.63). In this time period (...) , there was no difference in pregnancy rate between PGF2 alpha and untreated cows, but the difference in pregnancy rate between cows treated with cephapirin i.u. and with PGF2 alpha was not statistically significant. Treatment of postpartum endometritis should be reserved for cases diagnosed after 26 DIM, based on criteria that are associated with subsequent pregnancy rate.

2002 Journal of dairy science Controlled trial quality: uncertain

515. Use of methergine for the prevention of postoperative endometritis in non-elective cesarean section patients. Full Text available with Trip Pro

Use of methergine for the prevention of postoperative endometritis in non-elective cesarean section patients. Methergine increases constriction of uterine musculature which may facilitate sloughing of endometrial debris, close uterine vessels, and prevent post-cesarean endometritis. The objective of this study was to evaluate the efficacy of methergine in preventing endometritis in patients undergoing non-elective cesarean section delivery.Eighty patients undergoing non-elective cesarean (...) section were enrolled in a prospective randomized clinical trial of methergine (41) versus no methergine (39) administration during the postpartum period. The hospital records were abstracted after discharge to compare the postpartum course.There were no significant demographic differences between the two groups. The women receiving methergine had a significant reduction in the rate of postoperative endometritis (10% vs. 36%, P < 0.005). In addition, the mean postoperative hemoglobin was significantly

2000 Infectious diseases in obstetrics and gynecology Controlled trial quality: uncertain

516. Adjunctive intravaginal metronidazole for the prevention of postcesarean endometritis: a randomized controlled trial. (Abstract)

morbidity, wound infection, days on antibiotics, and length of postpartum hospitalization. Neonatal outcomes included birth weight, Apgar scores less than 7 at 5 minutes, umbilical arterial pH less than 7.16, admission and length of stay in the neonatal intensive care unit, and length of hospital stay.Of 112 patients receiving metronidazole, eight (7%) developed postcesarean endometritis, compared with 19 of 112 (17%) of those receiving placebo gel (relative risk 0.42, 95% confidence interval 0.19, 0.92 (...) Adjunctive intravaginal metronidazole for the prevention of postcesarean endometritis: a randomized controlled trial. To estimate the efficacy of preoperative administration of intravaginal metronidazole for the prevention of postcesarean endometritis.This double-masked, placebo-controlled randomized trial included patients of at least 24 weeks' gestation undergoing cesarean deliveries for various indications. Patients were randomized to receive either 5 g of metronidazole gel intravaginally

2001 Obstetrics and Gynecology Controlled trial quality: predicted high

517. Does uterine wiping influence the rate of post-Cesarean endometritis? (Abstract)

Does uterine wiping influence the rate of post-Cesarean endometritis? To compare two methods of uterine cleansing to remove residual amnion-chorion at the time of Cesarean delivery.All consenting uninfected parturients undergoing a non-emergency Cesarean delivery at the university were enrolled. All patients received antibiotic prophylaxis of a 1-g intravenous bolus of a first-generation cephalosporin immediately after cord clamping. Postpartum endometritis was defined as a temperature (...) including gestational age at time of Cesarean section, type of anesthesia used for the operative delivery, hours of amnion rupture prior to delivery, use of internal monitoring devices, type of skin incision, method of placental removal, total operative time and estimated blood loss were similar between patient groups (NS). An almost identical number of patients in each arm of the study developed post-Cesarean endometritis (65 out of 614, 10.5%, in the uterine wipe group vs. 66 out of 616, 10.7

2001 The Journal of maternal-fetal medicine Controlled trial quality: uncertain

518. Reproductive performance of dairy cows following treatment with fenprostalene, dinoprost, or cloprostenol between 24 and 31 Days post partum: a field trial. (Abstract)

treatment groups with respect to incidence of retained fetal membranes, endometritis, pyometra, anestrus, number of services per pregnancy, calving-to-first estrus interval, services per conception, number of prostaglandin treatments other than those administered between Days 24 and 31 post partum, the percentage culled for reproductive reasons and all factors combined. Cows receiving fenprostalene, dinoprost or cloprostenol had a decreased calving-to-conception interval compared (...) Reproductive performance of dairy cows following treatment with fenprostalene, dinoprost, or cloprostenol between 24 and 31 Days post partum: a field trial. Three hundred and one Holstein cows (n=301), calving at a commercial free-stall dairy farm, were randomly assigned to 1 of 3 prostaglandin treatment groups or a placebo group. The placebos were packaged 3 ways to mimic the 3 commercial prostaglandin preparations. Group 1 received 1 mg fenprostalene and 1.6 mg oxytetracycline; Group 2

1994 Theriogenology Controlled trial quality: uncertain

519. Postpartum ultrasound in women with postpartum endometritis, after cesarean section and after manual evacuation of the placenta. (Abstract)

Postpartum ultrasound in women with postpartum endometritis, after cesarean section and after manual evacuation of the placenta. To measure anteroposterior (AP) diameters, and to describe qualitative findings of the uterus and the uterine cavity in women with postpartum endometritis, after caesarean section (CS) and after manual evacuation of the placenta, and to compare these women with those in a normal puerperium.A prospective, descriptive, observational study of 103 postpartum women (...) was conducted. Fifty-five women had clinical symptoms of postpartum endometritis, 28 had undergone CS, and 20 had manual placental evacuation. Ultrasound examinations were scheduled for days 1, 3, 7, 14, 28 and 56 postpartum. Women with endometritis underwent their first examination on the day they presented with clinical symptoms.The AP diameters of the uterus and uterine cavity in all three groups overlapped considerably with the reference values. On day 56 postpartum, the uterus had achieved the same

2007 Acta Obstetricia et Gynecologica Scandinavica

520. The pharmacokinetics of once-daily dosing with gentamicin in women with postpartum endometritis. Full Text available with Trip Pro

The pharmacokinetics of once-daily dosing with gentamicin in women with postpartum endometritis. To evaluate the pharmacokinetics and cost of once-daily dosing with gentamicin in women with postpartum endometritis.Gentamicin in a single daily dose of 4.5 mg/kg was administered intravenously to 10 women with postpartum endometritis. Peak and trough gentamicin levels were measured, and nephrotoxicity and clinical ototoxicity were monitored. Pharmacokinetic data were analyzed, and a cost analysis (...) of once-daily gentamicin administration was performed.The mean elimination constant was 0.105 +/- 0.008 L/h, and the mean volume of distribution was 0.34 +/- 0.07 L/kg. Mean peak gentamicin levels exceeded 11 mg/L, and all trough levels were < 0.3 mg/L. Cost savings of 44% were achieved with once-daily dosing of gentamicin, compared with traditional thrice-daily dosing.Once-daily dosing with gentamicin in women with postpartum endometritis achieves therapeutic peak levels without drug accumulation

1998 Infectious diseases in obstetrics and gynecology

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