Endomyometritis after cesarean delivery in the era of antibiotic prophylaxis: incidence and risk factors |
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| Authors: | Laura J. Moulton Mark Lachiewicz Xiaobo Liu Oluwatosin Goje |
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| Affiliation: | 1. Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA;2. Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA;3. Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, OH, USA |
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| Abstract: | Purpose: To identify the rate of postpartum endomyometritis (PPE) after cesarean delivery (CD) in the era of antibiotic prophylaxis and determine risk factors.Methods: A single institution retrospective study was performed in women undergoing CD. Data regarding obstetrical and surgical variables were collected. Diagnosis of PPE was made clinically.Results: Among 2419 patients, the rate of PPE was 1.6% (n?=?38) and was associated with lower age (27.0 versus 31.0; p?p?p?=?.0081). There was no difference in PPE for cefazolin 2?g versus 1?g (OR: 1.91; p?=?.17) or 3?g versus 1?g (OR: 3.69; p?=?.29), gentamicin/clindamycin versus cefazolin (OR: 5.60; p?p?=?.001), sexually transmitted infection during the pregnancy (OR: 4.197; p?=?.02) or blood transfusion (OR: 9.50; p?Conclusions: While the overall rate of PPE was low, several risk factors were identified. Preoperative diagnosis of chorioamnionitits is associated with a higher rate of PPE. Further studies are needed to identify optimal regimens for antimicrobial prophylaxis in women undergoing CD. |
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| Keywords: | Postpartum endomyometritis cesarean delivery antibiotic prophylaxis |
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