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Postpartum Endometritis

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141. Routine Early vs Delayed Amniotomy for Preterm Pregnancies: A Randomized Open Label Trial

cm or they have been on an oxytocin drip for greater than 10 hours with no cervical change. It is possible that a woman in the late amniotomy group will not undergo AROM at all. The primary outcome under consideration is time in labor. Secondary outcomes include rates of chorioamnionitis, postpartum endometritis, mode of delivery, and neonatal outcomes. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 104 participants (...) for cesarean delivery Maternal/Labor Outcomes:Operative vaginal delivery [ Time Frame: at delivery ] Use of either a vacuum device or obstetrical forceps Maternal intrapartum fever or chorioamnionitis [ Time Frame: during labor to delivery ] Defined as persistent intrapartum fever and/or suspected or confirmed intraamniotic infection (20) Post-partum endometritis: [ Time Frame: up to 10 days ] defined as postpartum febrile morbidity in the absence of another causative factor (i.e. wound infection, deep

2018 Clinical Trials

142. Digital Cervical and Cesarean Section

University Study Details Study Description Go to Brief Summary: Cesarean delivery is one of the most commonly performed surgical operations worldwide Cesarean delivery even as an elective procedure has been associated with considerable maternal risks compared with vaginal delivery. Some of the complications include postpartum hemorrhage, uterine infection, urinary tract infection, wound infection, septicemia and maternal death. Over the years, many variations in the surgical technique of Cesarean (...) Caesarean section Procedure: Caesarean section Caesarean section will be done to deliver the baby Other: cervical dilatation Cervical dilatation will be done by double gloves digital dilatation postpartum Group A: non cervical dilatation patients who will have not cervical dilatation during Caesarean section Procedure: Caesarean section Caesarean section will be done to deliver the baby Other: No cervical dilatation after delivery of the baby cervix will be remain closed Outcome Measures Go to Primary

2018 Clinical Trials

143. Effect of Vaginal Douching With Betadine Before CS for Prevention of Post Operative Infections

: Betadine douches subjects received a vaginal preparation with povidone-iodine solution immediately prior to caesarean delivery Behavioral: Betadine douches subjects received a vaginal preparation with povidone-iodine solution immediately prior to caesarean delivery No Intervention: Non betadine douches subjects didnot received a vaginal preparation prior to caesarean delivery Outcome Measures Go to Primary Outcome Measures : Postpartum endometritis [ Time Frame: 6 weeks after Cesarean section

2018 Clinical Trials

144. Low Implanted Second Trimester Placenta and Placenta Previa

to. Although various studies have tried to address risk factors associated with Placenta Previa development, the etiology of placenta previa still remains obscure. Several risk actors have been identified as strong contributors to placenta previa development. It is also a significant contributor to severe postpartum hemorrhage.Risk factors include; history of previous cesarean section, advanced maternal age, history of previous abortions, high parity and substance abuse during pregnancy (cigarette smoking (...) ), placental size (multiple pregnancy), endometrial damage (previous dilatation and curettage), uterine scars and pathology (previous myomectomy or endometritis), placental pathology (marginal cord insertions and succenturiate lobes), previous placental Previa, and curiously. Condition or disease Intervention/treatment Placenta Previa Radiation: ultrasound Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 52 participants Observational Model: Cohort Time

2018 Clinical Trials

145. Antibiotic Prophylaxis in Ragged Placental Membranes

Hospital Study Details Study Description Go to Brief Summary: In some centres, women are routinely given a course of antibiotics postnatally if ragged placental membranes were present at delivery. The investigators examined the necessity such an intervention. Condition or disease Intervention/treatment Phase Endometritis Postpartum Endometritis Membranes; Retained Drug: Prophylactic antibiotics Other: No prophylaxis (Amox-clav withheld) Not Applicable Detailed Description: Postpartum endometritis (...) resulting in sepsis remain one of the leading cause of maternal mortality in developing countries. Ragged placental membrane is a risk factor for endometritis and is not infrequently encountered. Several hospitals in Malaysia, largely those geographically-removed currently practice administering prophylactic antibiotics for women with ragged placental membranes. The aim is to reduce the risk of postpartum endometritis in a subgroup of women who may present in dire straits. The investigators sought

2018 Clinical Trials

146. 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

147. Mechanical Dilatation of the Cervix at Elective Caesarean Section to Reduce Post-Operative Blood Loss

for national guideline development. Some obstetricians believe that the cervix of women at non-labor cesarean section is undilated and might cause obstruction of blood or lochia drainage, leading to postpartum hemorrhage and endometritis from the collection of lochia or debris. Dilatation of the cervix helps with the drainage of blood during postpartum, reducing intrauterine infection or the risk of postpartum hemorrhage. To avoid this problem, some obstetricians routinely dilate the cervix from above

2018 Clinical Trials

148. Foley Bulb Insertion Method: Blind vs. Direct

: Within 30 minutes of placement procedure ] In the time period immediately following placement Artificial rupture of membranes [ Time Frame: At time of placement of Foley bulb transcervical dilator ] Rupture of amniotic sac Chorioamnionitis or "triple I" [ Time Frame: From beginning of labor process until time of delivery ] Presumptive or confirmed diagnosis Endometritis [ Time Frame: From time of delivery to 30 days postpartum ] Postpartum intrauterine infection Eligibility Criteria Go to Information (...) bulb transcervical dilator. Outcome Measures Go to Primary Outcome Measures : Infection [ Time Frame: Labor to 30 days postpartum ] Pooled maternal infection Secondary Outcome Measures : Maternal fever [ Time Frame: From beginning of labor process to time of discharge, up to seven days ] Greater than or equal to 38 degrees Celsius Request for pain relief [ Time Frame: Within 30 minutes of placement procedure ] Request for IV pain medications or epidural placement Vaginal bleeding [ Time Frame

2018 Clinical Trials

149. Mechanical Dilation of the Cervix in a Scarred Uterus

, cord blood pH of ≤7.0, admission to NICU, neonatal hypoxic-ischaemic encephalopathy, neonatal death. Infectious complications [ Time Frame: Within 24-48hours of intervention ] intrauterine infection, maternal sepsis (e.g. endometritis, UTI), neonatal sepsis, maternal pyrexia, onset of antibiotics Labour complications [ Time Frame: Within 24-48hours of intervention ] uterine hyperstimulation (i.e. >5 contractions / 10mins with abnormal CTG), placental abruption, cord prolapse, postpartum haemorrhage

2018 Clinical Trials

150. Outpatient Foley For Starting Induction of Labor at Term in Nulliparous Women

: From baseline to delivery ] Rates of chorioamnionitis [ Time Frame: From baseline to delivery ] Rates of endometritis [ Time Frame: From delivery until 30 days post-discharge ] Mode of delivery [ Time Frame: From baseline to delivery ] Rates of vaginal delivery, cesarean delivery, and operative vaginal delivery (vacuum or forceps) Postpartum hemorrhage [ Time Frame: At delivery ] Rates of hospital readmission within 30 days [ Time Frame: From hospital discharge until 30 days post-discharge ] Rates

2018 Clinical Trials

151. Antibiotics During Intrauterine Balloon Tamponade Placement

Center Information provided by (Responsible Party): Kimberly Gregory, Cedars-Sinai Medical Center Study Details Study Description Go to Brief Summary: The goal of this study is to identify whether antibiotics given at the time of placement of an intrauterine balloon tamponade (IBT) will result in reduction of the risk of endometritis. The investigators hypothesize that antibiotics given at the time of intrauterine balloon tamponade will reduce the likelihood of postpartum endometritis. Condition (...) or disease Intervention/treatment Phase Obstetric Complication Postpartum Hemorrhage Postpartum Endometritis Drug: CeFAZolin 1000 MG Drug: Clindamycin 900 MG in 6 ML Injection Phase 4 Detailed Description: The investigators will perform a randomized, controlled trial of women who have had a postpartum hemorrhage and received an intrauterine balloon tamponade. Patients who are candidates for study enrollment will be identified on Labor & Delivery or in the Maternal-Fetal Care Unit. Patients who give

2018 Clinical Trials

152. Preterm Induction of Labor Timing of Amniotomy: A Randomized Controlled Trial

of the induction. ] Time (hours) from the start of induction (initiation of first cervical ripening agent) to vaginal delivery only Composite maternal morbidity [ Time Frame: Measured from start of induction of labor up to 42 days following delivery ] Composed of six outcomes: chorioamnionitis: defined as a clinical diagnosis before delivery endometritis: defined as a clinical diagnosis surgical site infection: infection within 30 days at the surgical site including wound reopened for infection or cellulitis (...) requiring antibiotics pneumonia: radiologic diagnosis of pneumonia accompanied by clinical signs/symptoms urinary tract infection: >100,000 colonies of a single species in urine culture accompanied by clinical signs/symptoms postpartum hemorrhage: estimated blood loss >1000 mL Composite neonatal morbidity [ Time Frame: Measured up to 28 days of life for the newborn ] Composed of five outcomes: perinatal death: death of a live fetus during labor or <28 days of life neonatal sepsis: critically ill infant

2018 Clinical Trials

153. Addition of Azithromycin to Cefazolin Will Reduce Post CS Infections More Than Cefazolin Only.

(at a dose of 1g) 2 hours preoperative. Study Group: This group will include 200women undergoing elective cs. In this group, patients will receive only standard prophylaxis antibiotic(CEFAZOLIN) Inclusion criteria: Gestational age of 37 0/7 weeks and greater Elective cesarean section Medicaly free pregnant women Exclusion criteria: a known allergy to azithromycin obstetric complications azithromycin use within 7 days before randomization chorioamnionitis or other infection requiring postpartum antibiotic (...) Group This group will include 200women undergoing elective cs. In this group, patients will receive only standard prophylaxis antibiotic(CEFAZOLIN) Outcome Measures Go to Primary Outcome Measures : endometritis [ Time Frame: 6 weeks after surgery ] Endometritis was defined as the presence of at least two of the following signs with no other recognized cause: fever (temperature of at least 38°C [100.4°F]), abdominal pain, uterine tenderness, or purulent drainage from the uterus Eligibility Criteria

2018 Clinical Trials

154. Routine Cervical Dilatation at the Non-labour Caesarean Section and Its Influence on Postoperative Pain

defined to reduce the risk of peri/post-operative morbidity. The digital dilatation of cervix during elective caesarean section has still been a concern when evaluating this issue. This procedure is supposed to help the drainage of blood and lochia postpartum, thus reducing infection or the risk of postpartum haemorrhage (PPH). However, on the contrary, this mechanical manipulation may also result in contamination by a vaginal micro-organism and increase the risk of infections or cervical trauma (...) in obstetrics. With the recent increase in the rate of this procedure, it is wise to understand and implement the optimal surgical technique. Therefore, different operational methods have been defined to reduce the risk of peri/post-operative morbidity. The digital dilatation of cervix during elective caesarean section has still been a concern when evaluating this issue. This procedure is supposed to help the drainage of blood and lochia postpartum, thus reducing infection or the risk of postpartum

2018 Clinical Trials

155. Effects of ACS in Twin With LPB: Study Protocol for a RCT

death Secondary Outcome Measures : Maternal complication [ Time Frame: 72 hours after birth ] Chorioamnionitis and Postpartum endometritis Respiratory distress syndrome [ Time Frame: 72 hours after birth ] Presence of clinical signs of respiratory distress (tachypnea, retractions, flaring, grunting, or cyanosis), with a requirement for supplemental oxygen with a fraction of inspired oxygen of more than 0.21 and a chest radiograph showing hypoaeration and reticulogranular infiltrates Transient

2018 Clinical Trials

156. Association of chorioamnionitis and its duration with adverse maternal outcomes by mode of delivery: a cohort study. (Abstract)

the duration of chorioamnionitis estimated from intrapartum antibiotic use, with adverse maternal outcomes was analysed using logistic regression with generalised estimating equations, adjusting for age, parity, race, pregestational diabetes, chronic hypertension, gestational age at delivery, study site and delivery year. Analyses were stratified by vaginal versus caesarean delivery.The composite adverse maternal outcome included: postpartum transfusion, endometritis, wound/perineal infection/separation (...) , venous thromboembolism, hysterectomy, admission to intensive care unit and/or death.Chorioamnionitis was associated with higher odds of the composite adverse maternal outcome with caesarean delivery (adjusted odds ratio 2.31; 95% CI 1.97-2.71); and the association persisted regardless of whether a woman had a trial of labour, preterm delivery or maternal group B streptococcus colonisation. The most common adverse outcomes after caesarean section were postpartum transfusion (56.0%) and wound/perineal

2018 BJOG

157. Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study. Full Text available with Trip Pro

Risk factors of premature rupture of membranes in public hospitals at Mekele city, Tigray, a case control study. The incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death

2018 BMC Pregnancy and Childbirth

158. 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 Full Text available with Trip Pro

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

2018 Journal of pregnancy

159. Prophylactic antibiotics for the prevention of infection following operative vaginal delivery (ANODE): study protocol for a randomised controlled trial Full Text available with Trip Pro

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

2018 Trials

160. Endometrial Stem Cells in Farm Animals: Potential Role in Uterine Physiology and Pathology Full Text available with Trip Pro

on the bovine species. In bovines, eMSCs have been identified during the phases of the estrous cycle, during which their functionality and the presence of eMSC-specific markers has been shown to change. Moreover, postpartum inflammation related to endometritis affects the presence and functionality of eMSCs, and prostaglandin E2 (PGE₂) may be the mediator of such changes. We demonstrated that exposure to PGE₂ in vitro modifies the transcriptomic profile of eMSCs, showing its potential role in the fate (...) of stem cell activation, migration, and homing during pathological uterine inflammation in endometritis and in healthy puerperal endometrium. Farm animal research on eMSCs can be of great value in translational research for certain uterine pathologies and for immunomodulation of local responses to pathogens, hormones, and other substances. Further research is necessary in areas such as in vivo location of the niches and their immunomodulatory and anti-infective properties.

2018 Bioengineering

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