Prevalence and Clinical Significance of PostpartumEndometritis and Wound Infection

摘要

Objective:To correlate clinical variables (gestational age, severe pregnancy-induced hypertension,gestational diabetes mellitus, history of previous cesarean sections, fetal distress, perinatal mortality,postpartum anemia, Apgar score ≤3 at 1 minute and ≤7 at 5 minutes, and instrumentaldelivery) with postpartum endometritis (PPE) and wound infection.Methods:Descriptive cross-sectional study of the outcome of 75,947 term and preterm singletondeliveries; vaginally and by cesarean section from 1989–1997.Results:The prevalence of PPE after vaginal deliveries was 0.17% (120/68,273). Gestational ageof less than 37 weeks, severe pregnancy-induced hypertension, fetal distress, instrumental deliveries,neonatal mortality, postpartum anemia, and Apgar scores of <7 after 5 minutes were significantlyassociated with PPE. Gestational diabetes and an Apgar score of <3 after 1 minute showedsimilar frequency with and without PPE. The prevalence of PPE after cesarean section was 2.63%(202/7,677). Preterm cesarean sections, history of previous cesarean sections, anemia, and lowApgar scores were seen more frequently with PPE than without. The incidence of cesarean deliverywith gestational diabetes mellitus, fetal distress, and perinatal mortality was similar in presenceand absence of PPE. The rate of wound infection after cesarean section was 3.97% (318/7,995).Gestational diabetes mellitus, history of previous cesarean deliveries, and low Apgar scores weresignificantly more frequent with than without wound infection. Gestational age, severe pregnancyinducedhypertension, fetal distress, perinatal mortality, and postpartum anemia were not associatedwith wound infection.Conclusions:Awareness of the aforementioned associations may prevent and shorten hospitalstay by early diagnosis and appropriate treatment. Infect. Dis. Obstet. Gynecol. 8:77–82; 2000.