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Postpartum Endometritis

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121. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. (Abstract)

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Retained placenta is a potentially life-threatening condition because of its association with postpartum hemorrhage. Manual removal of placenta increases the likelihood of bacterial contamination in the uterine cavity.To compare the effectiveness and side-effects of routine antibiotic use for manual removal of placenta in vaginal birth in women who received antibiotic prophylaxis and those who did (...) not and to identify the appropriate regimen of antibiotic prophylaxis for this procedure.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2014).All randomized controlled trials comparing antibiotic prophylaxis and placebo or non antibiotic use to prevent endometritis after manual removal of placenta in vaginal birth.There are no included trials. In future updates, if we identify eligible trials, two review authors will independently assess trial quality and extract dataNo studies

2014 Cochrane

122. Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. Full Text available with Trip Pro

) and postpartum endometritis (RR 0.50, 95% CI 0.18 to 1.38). However, there was a significant decrease in the risk of chorioamnionitis (RR 0.36, 95% CI 0.21 to 0.62). No serious adverse effects were reported. Drug resistance, duration of mechanical ventilation and duration of admission to NICU/hospital were not reported. Most of the domains for risk of bias were at low risk of bias for one study and at unclear risk of bias for the other study. The quality of the evidence using GRADE was low for neonatal (...) sepsis, postpartum endometritis, and neonatal mortality and morbidity prior to discharge (Neonatal intensive care admissions) and of moderate quality for chorioamnionitis.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

2014 Cochrane

123. High-dose versus low-dose oxytocin infusion regimens for induction of labour at term. Full Text available with Trip Pro

0.84, 95% CI 0.23 to 3.12; two trials), postpartum haemorrhage (RR 1.08, 95% CI 0.87 to 1.34; five trials), or endometritis (RR 1.35, 95% CI 0.53 to 3.43; three trials). Removal of high bias studies reveals a significant reduction of induction to delivery interval (MD -1.94 hours, 95% CI -0.99 to -2.89 hours, 489 women). A significant increase in hyperstimulation without specifying fetal heart rate changes was found in the high-dose group (RR 1.86, 95% CI 1.55 to 2.25).No other secondary outcomes

2014 Cochrane

124. Antibiotic prophylaxis for operative vaginal delivery. Full Text available with Trip Pro

endometritis and maternal length of stay.The data were too few to make any recommendations for practice. Future research on antibiotic prophylaxis for operative vaginal delivery is needed to conclude whether it is useful for reducing postpartum morbidity. (...) Antibiotic prophylaxis for operative vaginal delivery. Vacuum and forceps assisted vaginal deliveries are reported to increase the incidence of postpartum infections and maternal readmission to hospital compared to spontaneous vaginal delivery. Prophylactic antibiotics may be prescribed to prevent these infections. However, the benefit of antibiotic prophylaxis for operative vaginal deliveries is still unclear.To assess the effectiveness and safety of antibiotic prophylaxis in reducing

2014 Cochrane

125. Antibiotic regimens for management of intra-amniotic infection. Full Text available with Trip Pro

placebo after vaginal delivery showed no significant differences between groups in rates of treatment failure or postpartum endometritis. No significant differences were found in rates of neonatal death and postpartum endometritis when use of antibiotics was compared with no treatment. Four trials assessing two different dosages/regimens of gentamicin or dual-agent therapy versus triple-agent therapy, or comparing antibiotics, found no significant differences in most reported neonatal or maternal (...) in nearly 20% of term births and in 50% of preterm births. Women with chorioamnionitis have a two to three times higher risk for cesarean delivery and a three to four times greater risk for endomyometritis, wound infection, pelvic abscess, bacteremia, and postpartum hemorrhage.To assess the effects of administering antibiotic regimens for intra-amniotic infection on maternal and perinatal morbidity and mortality and on infection-related complications.We searched the Cochrane Pregnancy and Childbirth

2014 Cochrane

127. WHO guidelines for the treatment of Neisseria gonorrhoeae

. Pharyngeal infections are mainly asymptomatic, but mild sore throat and pharyngitis may occur. In the majority of women with gonorrhoea, the lack of discernible symptoms results in unrecognized and untreated infections. Untreated infections usually resolve spontaneously but may lead to serious complications such as pelvic inflammatory disease, including endometritis, salpingitis and tubo-ovarian abscess, which can lead to ectopic pregnancy and infertility. Untreated urethral infection in men can lead

2016 World Health Organisation Guidelines

128. The golden hour of sepsis: An in-depth analysis of sepsis-related maternal mortality in middle-income country Suriname. Full Text available with Trip Pro

and audit all maternal deaths in Suriname. All sepsis-related deaths were reviewed by a local expert committee to assess socio-demographic characteristics, clinical aspects and substandard care.Of all 65 maternal deaths in Suriname 29 (45%) were sepsis-related. These women were mostly of low socio-economic class (n = 23, 82%), of Maroon ethnicity (n = 14, 48%) and most deaths occurred postpartum (n = 21, 72%). Underlying causes were pneumonia (n = 14, 48%), wound infections (n = 3, 10%) and endometritis

2018 PLoS ONE

130. WHO recommendations for prevention and treatment of maternal peripartum infections

, and antibiotic prophylaxis for preventing infection in infection-prone conditions and obstetric procedures (prelabour rupture of membranes, meconium- stained amniotic fluid, perineal tears, manual removal of the placenta, operative vaginal birth and caesarean section). The recommendations on treatment of maternal peripartum infections are specific to antibiotic management of chorioamnionitis and postpartum endometritis. For each recommendation, the overall quality of evidence was graded as very low, low (...) should be used in preference to other classes of antibiotics. Conditional recommendation based on very low-quality evidence Treatment of peripartum infections 19. A simple regimen such as ampicillin and once-daily gentamicin is recommended as first-line antibiotics for the treatment of chorioamnionitis. Conditional recommendation based on very low-quality evidence 20. A combination of clindamycin and gentamicin is recommended as first-line antibiotics for the treatment of postpartum endometritis

2015 World Health Organisation Guidelines

131. Core Competencies for Management of Labour

of a Primary Care Provider. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 7 . Postpartum Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 8A. Obstetrical Emergencies – Cord Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 8B. Obstetrical Emergencies – Shoulder Dystocia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Perinatal Services BC Copyright © 2011 - PSBC MANAGEMENT (...) are defined as those with patient units or portions of patient units that are appointed for the specified purpose of providing intrapartum and postpartum care. • An RN who w or ks in a small r ur al hospit al or set ting that does not ha v e designat ed mat er nit y services is ethically obligated to provide the best care s/he can in the absence of the primary care provider, given the circumstances and her/his level of competence. 4. One-to-one Support in Labour • A w oman in activ e phase of labour

2014 British Columbia Perinatal Health Program

132. Antibiotic prophylaxis in ragged placental membranes: a prospective, multicentre, randomized trial. Full Text available with Trip Pro

Antibiotic prophylaxis in ragged placental membranes: a prospective, multicentre, randomized trial. Ragged placental membranes is a distinct entity from retained placenta and not uncommonly reported in midwifery texts. Although the incidence of postpartum endometritis is merely 1-5% after vaginal births, it remains the most common source of puerperal sepsis, contributing up to 15% of maternal mortality in low income countries. Geographically-remote centres in Malaysia prophylactically (...) to participate in the trial and randomized into prophylaxis or expectant management with medical advice by blocks of 10, at a 1:1 ratio. A medication adherence diary was provided and patients followed up at 2 weeks and 6 weeks postpartum.A total of 6569 women gave birth vaginally in three centres during the trial period, of which 10.9% had ragged membranes. The incidence of endometritis was not significantly raised in women with or without prophylaxis (0.90% vs 0.29%; p = 0.60). All cases of endometritis

2019 BMC Pregnancy and Childbirth Controlled trial quality: uncertain

133. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. (Abstract)

arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05).There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.

2012 Cochrane

134. Chlorhexidine Gluconate (CHG) for Suturing in the Emergency Room and Perineal Washing During Vaginal Deliveries: A Review of Safety, Evidence-Based Guidelines and Recommendations

and for perineal washing during vaginal deliveries? One systematic review examined the effectiveness of chlorhexidine vaginal douching during labour on maternal and neonatal outcomes. 5 This review included three RCTs for a total of 3012 pregnant women. When the data from the RCTs were pooled, there was no statistically significant difference in the maternal incidence of chorioamnionitis or postpartum endometritis between chlorhexidine and placebo groups. With regards to neonatal outcomes, no significant (...) the chlorhexidine and placebo groups (RR 1.10, 95% CI 0.86-1.42). Data from these three trials suggested a small reduction in the risk of postpartum endometritis in the chlorhexidine group, but the difference was not statistically significant (RR 0.83, 95% CI 0.61-1.13). One trial (n=910) found no significant difference in the incidence of neonatal pneumonia between the two groups (RR 0.33, 95% CI 0.01-8.09). One trial (n=1021) found no significant difference in neonatal meningitis between the two groups (RR

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

135. Bacterial Sepsis following Pregnancy

of the Centre for Maternal and Child Enquiries (CMACE) Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. 1 This topic is particularly relevant as there has been a dramatic rise in maternal deaths attributable to group A beta-haemolytic streptococci (GAS) (three in 2000–2002 2 and 13 in 2006–2008). 1 The most common site of sepsis in the puerperium is the genital tract and in particular the uterus, resulting in endometritis. This guideline covers the recognition of febrile (...) bacterial illness in the postpartum period – including postabortion sepsis – arising in the genital tract or elsewhere, investigations to identify and characterise sepsis in the puerperium, and management strategies. The population covered includes women in the puerperium (i.e. within 6 weeks of giving birth) with suspected or diagnosed bacterial sepsis in primary or secondary care. Sepsis in pregnancy is covered by a parallel guideline. Sepsis arising owing to viral or parasitic agents is outside

2012 Royal College of Obstetricians and Gynaecologists

136. Caesarean section

2011] Offer women prophylactic antibiotics at CS to reduce the risk of postoperative infections. Choose antibiotics effective against endometritis, urinary tract and wound infections, which occur in about 8% of women who have had a CS. [new 2011] [new 2011] Do not use co-amoxiclav when giving antibiotics before skin incision. [new 2011] [new 2011] Reco Recov very following CS ery following CS While women are in hospital after having a CS, give them the opportunity to discuss with healthcare (...) birth for women with an uncomplicated pregnancy and no pre an uncomplicated pregnancy and no previous caesarean section vious caesarean section Planned caesarean section may reduce the risk of the following in women: perineal and abdominal pain during birth and 3 days postpartum injury to vagina early postpartum haemorrhage obstetric shock. Planned caesarean section may increase the risk of the following in babies: neonatal intensive care unit admission. Planned caesarean section may increase

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Comparison of Insulin Alone to Insulin With Metformin to Treat Gestational Diabetes Mellitus

disorder of pregnancy [ Time Frame: from enrollment through study completion (30 days after delivery) ] gestational HTN, superimposed pre-eclampsia, pre-eclampsia-eclampsia Incidence of composite of adverse maternal outcomes [ Time Frame: from enrollment through study completion (30 days after delivery) ] death, ICU admission, postpartum hemorrhage, blood transfusion, organ failure, chorioamnionitis/endometritis Breast feeding status [ Time Frame: Will be recorded at the time of hospital discharge (...) was collected as part of routine care prior to enrollment, this value will be compared to the hemoglobin A1c collected at delivery Incidence of maternal side effects [ Time Frame: Will be assessed weekly until delivery ] maternal reported medication side effects (i.e. nausea, vomiting, diarrhea) Treatment acceptability [ Time Frame: Will be collected postpartum after delivery ] determined using Diabetes Treatment Satisfaction Questionnaire. Survey includes 8 questions that are answered on a scale of 0-6; 0

2018 Clinical Trials

138. Pedometers for the Enhancement of Post Cesarean Mobility

Measures : Number of participants with a postpartum complication composite [ Time Frame: 48 hours ] Composite of postpartum complications, including infectious (endometritis, wound), blood product transfusion Number of analgesic doses [ Time Frame: 48 hours ] Number of doses of analgesics consumed by patient Length of hospitalization [ Time Frame: From 72 hours to one week ] Duration of postpartum hospitalization Number of thromboembolic events [ Time Frame: Six weeks ] Thromboembolic events during

2018 Clinical Trials

139. Comparison of Misoprostol Ripening Efficacy With Dilapan

or Misoprostol for cervical ripening Percentage of women who developed endometritis within 14 days of intervention [ Time Frame: From delivery until two weeks after discharge (approximately up to 3 weeks) ] This is to measure the safety of either Dilapan or Misoprostol for cervical ripening Percentage of women who developed postpartum hemorrhage [ Time Frame: From delivery until two weeks after discharge (approximately up to 3 weeks) ] This is to measure the safety of either Dilapan or Misoprostol (...) for cervical ripening, postpartum hemorrhage is defined as estimated blood loss (EBL) > 1000cc and/or drop in Hematocrit (HCT) by 10 points. Percentage of newborns with Apgar score <7 at 5 min [ Time Frame: From birth until two weeks after birth ] This is to measure the safety of either Dilapan or Misoprostol for cervical ripening by studying the effect on newborns Percentage of newborns with cord arterial blood potential hydrogen (pH) < 7 [ Time Frame: From birth until two weeks after birth

2018 Clinical Trials

140. Impact of Uterine Closure Techniques on the Cesarean Scar Thickness After Repeated Cesarean Section

and postoperatively 48 hours Blood product transfusion [ Time Frame: One week after cesarean ] unite number of transfused packed erythrocyte Maternal infectious morbidity [ Time Frame: six weeks after cesarean ] prevalence of postpartum endometritis, skin wound dehiscence and post operative fever. Length of hospitalization [ Time Frame: One month after cesarean ] Duration in days Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important

2018 Clinical Trials

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