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Postpartum Endometritis

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121. Antibiotic prophylaxis for operative vaginal delivery. (PubMed)

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

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2014 Cochrane

122. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. (PubMed)

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

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2014 Cochrane

123. Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial. (PubMed)

participants (n = 1204) were instructed to wait 60 minutes.The primary outcome was spontaneous vaginal delivery. Secondary outcomes included total duration of the second stage, duration of active pushing, operative vaginal delivery, cesarean delivery, postpartum hemorrhage, chorioamnionitis, endometritis, perineal lacerations (≥second degree), and a composite outcome of neonatal morbidity that included neonatal death and 9 other adverse outcomes.Among 2414 women randomized (mean age, 26.5 years), 2404 (...)  < .001), lower rates of chorioamnionitis (6.7% vs 9.1%; between-group difference, -2.5% [95% CI, -4.6% to -0.3%], P = .005), and fewer postpartum hemorrhages (2.3% vs 4.0%; between-group difference, -1.7% [95% CI, -3.1% to -0.4%], P = .03).Among nulliparous women receiving neuraxial anesthesia, the timing of second stage pushing efforts did not affect the rate of spontaneous vaginal delivery. These findings may help inform decisions about the preferred timing of second stage pushing efforts, when

2018 JAMA

124. Institutional Protocols for Vaginal Preparation With Antiseptic Solution and Surgical Site Infection Rate in Women Undergoing Cesarean Delivery During Labor

in laboring patients with viable pregnancies. The primary outcome for this analysis was the rate of superficial or deep surgical site infection within 6 weeks postpartum, as per Centers for Disease Control and Prevention criteria. Maternal secondary outcomes included a composite of endometritis, wound infection or other infections, postoperative maternal fever, length of hospital stay, and the rates of hospital readmission, unexpected office visits, and emergency department visits.A total of 523 women

2018 EvidenceUpdates

125. Birth after Previous Caesarean Birth

encephalopathy (HIE). • < 1 per 10 000 ( < 0.01%) risk of delivery- related perinatal death or HIE. • 4 per 10 000 (0.04%) risk of delivery-related perinatal death. This is comparable to the risk for nulliparous women in labour. The estimates of risk for adverse maternal or fetal events in VBAC are based on women receiving continuous electronic monitoring during their labour. Hysterectomy and other morbidities The rates of hysterectomy, thromboembolic disease, transfusion and endometritis did not differ (...) significantly between planned VBAC and ERCS according to the AHRQ meta-analysis 9 and another meta-analysis. 74 However, the NICHD study showed unsuccessful compared with Evidence level 2+RCOG Green-top Guideline No. 45 © Royal College of Obstetricians and Gynaecologists 11 of 31 successful VBAC increased the risk of uterine rupture (2.3% versus 0.1%), hysterectomy (0.5% versus 0.1%), transfusion (3.2% versus 1.2%) and endometritis (7.7% versus 1.2%). 18 Meta- analysis has shown that hysterectomy

2015 Royal College of Obstetricians and Gynaecologists

126. Efficacy of homeopathic remedies as prophylaxis of bovine endometritis. (PubMed)

Efficacy of homeopathic remedies as prophylaxis of bovine endometritis. The objective of this study was to evaluate the efficacy of 2 different homeopathic prophylactic strategies for the prevention of endometritis. The drugs used were Lachesis compositum (Lachesis), Carduus compositum (Carduus), and Traumeel LT (Traumeel). Each drug contained a mixed formula of homeopathic remedies. All 929 cows received the first treatment within 24 h postpartum. The second to fourth treatments were conducted (...) at 7 to 13, 14 to 20, and 21 to 27 d in milk, respectively. In the first group, the 4 treatments were Traumeel, Lachesis, Carduus, and Carduus, respectively (n = 206). In the second group, Lachesis was administered 3 times, followed by 1 treatment with Carduus (n = 198). The control group received 4 injections of saline (n = 189). In the fourth week after calving, the prevalence of clinical endometritis, uterine involution, and ovarian activity was monitored by rectal palpation

2009 Journal of dairy science

127. Reduction of Endometritis After Cesarean Section With the Routine Use of Methergine

received Methergine 0.2mg po every 6 hours for two days, plus routine postpartum care. Drug: Methergine Scheduled methergine 0.2 mg PO every 6hrs for duration of postpartum stay No Intervention: No treatment No treatment group received only routine postpartum care. Outcome Measures Go to Primary Outcome Measures : Endometritis Incidence [ Time Frame: One year ] Number of participants who developed endometritis Eligibility Criteria Go to Information from the National Library of Medicine Choosing (...) Reduction of Endometritis After Cesarean Section With the Routine Use of Methergine Reduction of Endometritis After Cesarean Section With the Routine Use of Methergine - Full Text View - Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2009 Clinical Trials

128. 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

129. 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

130. Antibiotic prophylaxis in ragged placental membranes: a prospective, multicentre, randomized trial. (PubMed)

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

132. 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

133. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement

restriction (FGR) h Delivery Cesearean section/operative deliveries Small or large for gestational age (SGA/LGA), i preterm delivery (PTD), j anomalies detected by obstetrical screening Postpartum and neonatal/infancy Thromboembolism, postpartum depression, Lactation rates Anomalies detected after birth, neonatal intensive care unit admission, length of stay a A death of male or female parent or fetus/infant participating in trials should be reported. b OHSS (ovarian hyperstimulation syndrome

2014 Society for Assisted Reproductive Technology

134. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. (PubMed)

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

135. Menopause Chapter 3: Clinical Issues

no anatomic pathology. In addition to perimenopausal anovulation, irregular bleeding can be caused by anovulation associated with thyroid abnormalities, hyperprolactinemia, or polycystic ovarian syndrome. Anatomic causes of abnormal uterine bleeding (AUB) include polyps, fibroids, endometritis, endometrial hyperplasia, and cancer. Evaluation of AUB may include the following laboratory tests, based on the clinical situation: complete blood count, pregnancy test, coagulation profile, sexually transmitted (...) the menopause transition. A history of premenstrual syndrome or postpartum depression is a strong risk factor for mood symptoms at midlife. Life stressors are common at midlife and often coincide with the menopause transition. Recommendations for Clinical Care Healthcare providers should screen for psychological symptoms at midlife and treat psychological problems when indicated or provide appropriate referrals. (Level II) Mild depressive symptoms respond well to psychotherapy. Moderate or severe depressive

2014 The North American Menopause Society

136. Clinical practice guideline for care in pregnancy and puerperium

. What are the tools with better performance in the detection of mental disorders during the puerperium? 80. Does the contact of the mother with other mother networks and support groups reduce the risk of mental problems and postpartum depression? Breastfeeding 81. What practices favour the establishment of breastfeeding during the puerperium? 82. What practices help to maintain breastfeeding during the puerperium? 83. What is the most appropriate treatment for the cracks in the nipple, breast (...) that may involve risk of abdominal trauma; falls or excessive joint stress as well as diving can cause problems at birth and provoke the decompression illness (DCI) of the foetus. Psychological changes of pregnancy. Psychosocial stress and affective disorders Weak We suggest carring out a screening of the psychosocial status of the pregnant woman when there is suspicion of a material factor that may affect the course of pregnancy or postpartum. v Health professionals should be alert to the signs

2014 GuiaSalud

137. The impact of time of delivery on gestations complicated by preterm premature rupture of membranes: daytime versus nighttime. (PubMed)

no differences in demographic maternal variables. There were no differences in the number of patients receiving steroids and the doses of steroids. Antibiotic prophylaxis was also equal in both groups. Postpartum endometritis, chorioamnionitis, and the latency to delivery were also equivalent between both the groups. Cesarean delivery for distress was the only different outcome, more prevalent in daytime deliveries (157 (44.7%) versus 108 (35.9%) of the nighttime ones p = .02). Neonatal adverse outcomes

2018 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

138. Trichomonas vaginalis Transports Virulent Mycoplasma hominis and Transmits the Infection to Human Cells after Metronidazole Treatment: A Potential Role in Bacterial Invasion of Fetal Membranes and Amniotic Fluid (PubMed)

Trichomonas vaginalis Transports Virulent Mycoplasma hominis and Transmits the Infection to Human Cells after Metronidazole Treatment: A Potential Role in Bacterial Invasion of Fetal Membranes and Amniotic Fluid Mycoplasma hominis is considered an opportunistic pathogen able to colonize the lower urogenital tract; in females the infection is associated with severe pregnancy and postpartum complications, including abortion, endometritis, preterm delivery, and low birth weight. Molecular

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2018 Journal of pregnancy

139. Prophylactic antibiotics for the prevention of infection following operative vaginal delivery (ANODE): study protocol for a randomised controlled trial (PubMed)

describes a multicentre, randomised, blinded, placebo-controlled trial aiming to recruit 3424 participants from over 20 hospital sites in the UK. Women who have undergone an operative vaginal delivery at 36+0 weeks or greater gestation with no indication for ongoing antibiotics in the postpartum period and no contra-indications to prophylactic co-amoxiclav, will be randomised to receive a single intravenous dose of co-amoxiclav or placebo. The primary outcome will be confirmed or suspected maternal (...) infection within 6 weeks of delivery, as defined by one of (a) a new prescription of antibiotics for presumed perineal wound-related infection, endometritis or uterine infection, urinary tract infection with systemic features or other systemic infection, (b) systemic infection confirmed with a culture or (c) endometritis as defined by the US Centers for Disease Control and Prevention. Outcome information will be collected by a single telephone interview and questionnaire, with clinical data collected

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2018 Trials

140. Preoperative Application of Chlorhexidine to Reduce Infection With Cesarean Section After Labor

% chlorhexidine gluconate) in addition to routine IV antibiotics. Drug: 2% chlorhexidine gluconate cloth applied to their abdomen Other Name: 2% Chloraprep solution Outcome Measures Go to Primary Outcome Measures : Rate of surgical site infection [ Time Frame: up to 6 weeks postpartum ] Surgical site infection will be a composite of wound infection and postpartum endometritis. Endometritis is defined as postoperative fever of 100.4 °F or more occurring 24 hours after delivery associated with uterine (...) . In obstetric patients, infectious morbidity (i.e. SSI, endometritis) occurs in 5-10% of cesarean sections, which is 5-fold higher than vaginal deliveries. Additionally, infectious morbidity is thought to be highest in those patients who have cesarean sections after undergoing labor. Chlorhexidine, a chemical antiseptic effective on gram positive and gram negative bacteria, reduces skin microflora/colonization but it is not clear if it decreases the risk of SSI. Historically, chlorhexidine has been studied

2018 Clinical Trials

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