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Postpartum Endometritis

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141. 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

142. Women's perspectives on caesarean section recovery, infection and the PREPS trial: a qualitative pilot study. Full Text available with Trip Pro

Women's perspectives on caesarean section recovery, infection and the PREPS trial: a qualitative pilot study. In England, 27.8% of all pregnant women undergo caesarean sections (CS) to deliver their babies. Women undergoing CS are at risk of developing sepsis and post-natal infections, which not only contribute significantly to maternal mortality and morbidity, but also negatively impact upon post-natal recovery and wellbeing. This study explores patients' priorities in relation to CS recovery (...) , focusing on their knowledge and experiences of infection prevention. The study formed part of the PREPS (Vaginal Preparation at caesarean section to Reduce Endometritis and Prevent Sepsis - a feasibility study of chlorhexidine) Trial; patients' views on the PREPS Trial were also sought.Using qualitative methodology, two focus groups and six telephone interviews were carried out between September and October 2017 with a total of 21 women who had undergone a CS within the preceding six months. Focus

2019 BMC Pregnancy and Childbirth

143. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. Full Text available with Trip Pro

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

144. Antibiotics for the Prevention of Post-Cesarean Section Complications: Clinical Evidence and Safety

to a 50% reduction in maternal infections. Studies comparing the two strategies were not identified. Both antibiotic regimens were found to be effective in reducing maternal infections. Future studies examining neonatal outcomes and antibiotic resistance were suggested. Constantine et al., 2008 4 To examine the effects of timing of antibiotic prophylaxis during c-section. Pre-operative administration of antibiotics significantly reduced the risk of post-partum endometritis and the total number (...) in the timing of antibiotic administration for the prevention of post-c- section complications. Pre-incision administration resulted in lower rates of endometritis (2.2% vs. 3.9%) and wound infection (2.5% vs. 3.6%) compared with administration following cord clamping without having any negative effects on neonatal infection rates or health. Authors concluded that antibiotic administration should occur prior to skin incision. Kaimal et al., 2008 13 To examine the effect of a policy change in SSI rates fell

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

145. How should Bacterial Vaginosis be Managed in Pregnancy?

is unreliable, even with previous BV history. 1 In Canada, BV prevalence is 14% in pregnancy. 4 50-75% of women with BV are asymptomatic. 1 WHAT OBSTETRIC & GYNAECOLOGICAL COMPLICATIONS ARE ASSOCIATED WITH BV IN PREGNANCY? 1,4 ? BV is linked to threatened preterm labour (TPTL) & preterm delivery (PTD), preterm premature rupture of membranes (PPROM), spontaneous abortions, chorioamnionitis, post-partum endometritis, post-Cesarean delivery wound infections, post-surgical infections, & subclinicial pelvic

2013 RxFiles

146. 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

147. Bacterial Sepsis following Pregnancy

Bacterial Sepsis following Pregnancy Bacterial Sepsis following Pregnancy Green–top Guideline No. 64b April 2012RCOG Green-top Guideline No. 64b 2 of 21 © Royal College of Obstetricians and Gynaecologists Bacterial Sepsis following Pregnancy This is the first edition of this guideline. 1. Purpose and scope The purpose of this guideline is to provide guidance on the management of sepsis in the puerperium (i.e. sepsis developing after birth until 6 weeks postnatally), in response to the findings (...) 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

2012 Royal College of Obstetricians and Gynaecologists

148. 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

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

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 Controlled trial quality: uncertain

150. Azithromycin-based Extended-Spectrum Antibiotic Prophylaxis for Cesarean: Role of Placental Colonization with Genital Ureaplasmas and Mycoplasmas. (Abstract)

prophylaxis at cesarean. Chorioamnion/placenta specimens were tested for genital mycoplasmataceae colonization by polymerase chain reaction. Primary outcome was a composite of endometritis, wound infection, or other infections up to 6 weeks postpartum. Analysis was intent-to-treat; logistic regression was used to evaluate interactions between treatment assignment (AZI/placebo) and the presence/absence of mycoplasmataceae and to quantify effects of AZI in analyses stratified by the presence/absence (...) (OR: 0.49; 95% CI: 0.24-1) of mycoplasmataceae. Results were similar with endometritis/wound infections and with ureaplasmas/mycoplasmas considered separately. The reduction in postcesarean infection with AZI does not vary based on the presence or absence of genital mycoplasmataceae placental colonization.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

2018 American journal of perinatology Controlled trial quality: predicted high

151. The effect of mechanical cervical dilatation during scheduled cesarean section on the blood loss: a randomized controlled trial. (Abstract)

and haematocrit levels in group II (p = 0.014 and 0.033 respectively). The mean duration of CS was significantly shorter in the cervical dilatation group (p = 0.002). No difference between both groups regarding the rate of postpartum hemorrhage (PPH) (p = 0.21), the duration of hospital stay (p = 0.17), the rate of wound infection (p = 0.32), the rate of endometritis (p = 0.82).Mechanical cervical dilatation during scheduled CS could be associated with lower postoperative blood loss, higher postoperative (...) spinal anesthesia if they met our inclusion criteria. Eligible participants were randomized to one of two groups. Group (I): Women with intraoperative cervical dilatation and Group (II): women with no intraoperative cervical dilatation. The primary outcome of this study was the mean volume of total blood loss during CS. The secondary outcomes included the mean reduction in the hemoglobin and hematocrit, the rate of primary postpartum hemorrhage, the duration of surgery, the duration of hospital stay

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 Controlled trial quality: predicted high

152. 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

153. 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 (...) Uterus (MEDICS) 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03471858 Recruitment Status : Not yet recruiting First Posted : March 21, 2018 Last Update Posted : August 16, 2018 See Sponsor: Ministry of Health, Singapore

2018 Clinical Trials

154. 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 (...) . Outpatient Foley For Starting Induction of Labor at Term in Nulliparous Women (OFFSITE II) 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03472937 Recruitment Status : Recruiting First Posted : March 21, 2018 Last Update

2018 Clinical Trials

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

Addition of Azithromycin to Cefazolin Will Reduce Post CS Infections More Than Cefazolin Only. Addition of Azithromycin to Cefazolin Will Reduce Post CS Infections More Than Cefazolin Only. - Full Text View - ClinicalTrials.gov 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 adding more. Addition of Azithromycin to Cefazolin Will Reduce Post CS Infections More Than Cefazolin Only. 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03502356 Recruitment Status : Recruiting

2018 Clinical Trials

156. 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

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

. Preterm Induction of Labor Timing of Amniotomy: A Randomized Controlled Trial (PITA) 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03504670 Recruitment Status : Recruiting First Posted : April 20, 2018 Last Update Posted (...) 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

2018 Clinical Trials

158. 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 (...) ) 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03450408 Recruitment Status : Recruiting First Posted : March 1, 2018 Last Update Posted : July 11, 2018 See Sponsor: The University of Texas Medical Branch, Galveston

2018 Clinical Trials

159. 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 (...) : Recruiting First Posted : August 23, 2018 Last Update Posted : August 24, 2018 See Sponsor: Ataturk University Information provided by (Responsible Party): Ragıp Atakan Al, Ataturk University Study Details Study Description Go to Brief Summary: We compares two techniques of uterine closure on myometrium thickness at the site of uterine scar of women who underwent repeated cesarean section. We will evaluate myometrial thickness by transvaginal ultrasound six months after cesarean. Condition or disease

2018 Clinical Trials

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

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 (...) 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

2018 Clinical Trials

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