Postpartum Endometritis Clinical Trial
Cesarean delivery rates are increasing in Turkey and a major component of this increase is
cesarean on demand. Although data on the rate of cesarean delivery in Turkey is limited, a
national study reported a rate of 23.8%. Infectious morbidity, consisting primarily of
endomyometritis and wound infection, remains a leading cause of postoperative complications.
Estimates of postcesarean infection rates range from 7% to 20%, depending on demographic and
obstetric variables. Infection following cesarean delivery results in not only increased
hospital stay but also increases the cost of care. Strategies to minimize postoperative
infectious and other morbidities have included modifications of surgical technique, changing
of gloves, methods of placental delivery, cervical dilatation during cesarean delivery, and
altering the uterine position during repair of the uterine incision. Despite these
interventions, endometritis is still major problem after cesarean delivery.
Endometritis appears to result from ascending vaginal flora bacteria, with anaerobes playing
an important role. The microbes endogenous to the vagina change throughout the course of
pregnancy and parturition. Larsen and Galask noted that anaerobic species located in the
vagina increase dramatically by the third postpartum day. In many cases, the surgeon's hand,
reaching below the infant's head or presenting part, is in direct contact with the vagina.
Vaginal bacterial flora have been cultured from the delivering surgeon's glove in 79% (95%
confidence interval [CI] 58%, 100%) of cesareans that follow labor. In these cases, vaginal
flora are delivered directly to the uterus, abdominal cavity, and the abdominal incision.
Vaginal preparation has been shown to decrease the quantitative load of vaginal
microorganisms as well as to remove certain species of bacteria.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Terminated |
NCT05603624 -
Effect of Sterile Versus Clean Gloves Intrapartum and Postpartum Infections at Term
|
N/A | |
| Completed |
NCT04385680 -
Chlorhexidine Vaginal Preparation for Reduction of Post-cesarean Endometritis and Sepsis
|
Phase 1/Phase 2 | |
| Terminated |
NCT03478163 -
Antibiotics During Intrauterine Balloon Tamponade Placement
|
Phase 4 | |
| Not yet recruiting |
NCT03840889 -
Secondary Postpartum Hemorrhage
|
||
| Completed |
NCT03248297 -
Antibiotic Prophlaxis for High-risk Laboring Women in Low Income Countries
|
Phase 4 | |
| Completed |
NCT05118984 -
Efficacy of Azithromycin in MSAF Cases to Improve Maternal and Neonatal Outcomes
|
Phase 4 |