Endometritis Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2007;29(5):260-266
DOI 10.1590/S0100-72032007000500007
PURPOSE: to evaluate puerperal morbidity in HIV-infected and HIV non-infected puerperal women. METHODS: longitudinal and controlled study performed from July 2001 to September 2003, in 205 pregnant women admitted for birth delivery at Odete Valadares Maternity, divided in two groups: HIV-infected women (82) and HIV non-infected women (123). Postpartum morbidity evaluation was performed from birth delivery up to 15 days postpartum. Morbidity was categorized as minor (postpartum hemorrhage, fever and endometritis) or major (blood transfusion, deep alterations of the surgical wound and indication for surgical intervention), and was evaluated both according to the presence or absence of HIV infection and the mode of delivery. Continuous variables were analyzed by the Student’s t-test, and categorical variables were analyzed by chi2 and Fisher’s exact test using Epi-Info 2000 (CDC, Atlanta). RESULTS: puerperal morbidity was observed in 18 patients from the HIV group (22%) and in 17 patients from the control group (14%) with predominance of minor morbidity, without statistical significance, except for an increased risk of endometritis in the HIV group (RR=1.05; CI 95%:1.01-1.10). No significant difference was observed concerning the mode of delivery between the two groups. There were only two major morbidities: blood transfusion and necrotizing fasciitis. CONCLUSIONS: HIV-infected and non-infected puerperal women have a similar morbidity, despite the lower morbidity in the HIV non-infected group and the increased risk of endometritis in the HIV group. Clinical puerperium follow-up is a strategic control tool for an early identification of maternal morbidity.
Summary
Rev Bras Ginecol Obstet. 2007;29(5):260-266
DOI 10.1590/S0100-72032007000500007
PURPOSE: to evaluate puerperal morbidity in HIV-infected and HIV non-infected puerperal women. METHODS: longitudinal and controlled study performed from July 2001 to September 2003, in 205 pregnant women admitted for birth delivery at Odete Valadares Maternity, divided in two groups: HIV-infected women (82) and HIV non-infected women (123). Postpartum morbidity evaluation was performed from birth delivery up to 15 days postpartum. Morbidity was categorized as minor (postpartum hemorrhage, fever and endometritis) or major (blood transfusion, deep alterations of the surgical wound and indication for surgical intervention), and was evaluated both according to the presence or absence of HIV infection and the mode of delivery. Continuous variables were analyzed by the Student’s t-test, and categorical variables were analyzed by chi2 and Fisher’s exact test using Epi-Info 2000 (CDC, Atlanta). RESULTS: puerperal morbidity was observed in 18 patients from the HIV group (22%) and in 17 patients from the control group (14%) with predominance of minor morbidity, without statistical significance, except for an increased risk of endometritis in the HIV group (RR=1.05; CI 95%:1.01-1.10). No significant difference was observed concerning the mode of delivery between the two groups. There were only two major morbidities: blood transfusion and necrotizing fasciitis. CONCLUSIONS: HIV-infected and non-infected puerperal women have a similar morbidity, despite the lower morbidity in the HIV non-infected group and the increased risk of endometritis in the HIV group. Clinical puerperium follow-up is a strategic control tool for an early identification of maternal morbidity.
Summary
Rev Bras Ginecol Obstet. 2005;27(8):456-460
DOI 10.1590/S0100-72032005000800004
PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4%) or normal delivery (47.6%). The sample was characterized by low socioeconomic and educational levels. The patients were submitted to a regimen of exclusive parenteral antibiotic, only during the hospitalization period (ATP-EX group). These results were compared with results obtained in a historical cohort in the same hospital (20 cases) submitted to a regimen of hospital parenteral antibiotic therapy complemented with ambulatory oral treatment (ATP+VO group). The patients were evaluated clinically on the occasion of periodic return visits in order to identify cases of recurrence and infectious complications. RESULTS: one patient from the ATP+VO group needed to be readmitted to the hospital on the 6th day after her discharge from the hospital with a diagnosis of endometritis recrudescence. No complications were observed among patients from ATP-EX group. CONCLUSION: for the treatment of puerperal endometritis, there was no additional advantage in using supplementary oral antibiotic therapy after patient discharge. The results using exclusive parenteral antibiotic treatment during hospitalization time indicate that it is effective and can be safely used in a population of low socioeconomic level.
Summary
Rev Bras Ginecol Obstet. 2005;27(8):456-460
DOI 10.1590/S0100-72032005000800004
PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4%) or normal delivery (47.6%). The sample was characterized by low socioeconomic and educational levels. The patients were submitted to a regimen of exclusive parenteral antibiotic, only during the hospitalization period (ATP-EX group). These results were compared with results obtained in a historical cohort in the same hospital (20 cases) submitted to a regimen of hospital parenteral antibiotic therapy complemented with ambulatory oral treatment (ATP+VO group). The patients were evaluated clinically on the occasion of periodic return visits in order to identify cases of recurrence and infectious complications. RESULTS: one patient from the ATP+VO group needed to be readmitted to the hospital on the 6th day after her discharge from the hospital with a diagnosis of endometritis recrudescence. No complications were observed among patients from ATP-EX group. CONCLUSION: for the treatment of puerperal endometritis, there was no additional advantage in using supplementary oral antibiotic therapy after patient discharge. The results using exclusive parenteral antibiotic treatment during hospitalization time indicate that it is effective and can be safely used in a population of low socioeconomic level.