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Re: 'cleared of all clot and debris' - was: no subject received Wed, 3 May 2006 09:02:42 -0500 From: D. Ashley Hill (dahmd@cfl.rr.com) Thu May 4 21:00:49 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: cesarean art" Previous message: Raymond Stephen: "Re: quadruplet" In reply to: Raymond Stephen: "Re: "cleared of all clot and debris" - was: no subject received Wed, 3 May 2006 09:02:42 -0500" Next in thread: Dr Eberhard W Lisse: "Re: 'cleared of all clot and debris' - was: no subject received Wed, 3 May 2006 09:02:42 -0500" Try this: no difference between wiping and non-wiping with regards to endomyometritis. J Matern Fetal Med. 2001 Oct;10(5):318-22. Does uterine wiping influence the rate of post-Cesarean endometritis? Magann EF, Chauhan SP, Martin JN Jr, Bryant KS, Bufkin L, Morrison JC. METHODS: All consenting uninfected parturients undergoing a non-emergency Cesarean delivery at the university were enrolled. All patients received antibiotic prophylaxis of a 1-g intravenous bolus of a first-generation cephalosporin immediately after cord clamping. Postpartum endometritis was defined as a temperature of > or = 100.4 degrees F (38 degrees C) on two occasions 6 h apart after the first 24 h with uterine tenderness and/or foul-smelling lochia. RESULTS: Between January 1998 and February 2000 there were 1400 patients enrolled in this investigation. A total of 153 women were determined to have chorioamnionitis present at surgery and 17 women refused participation, leaving 614 women in the uterine wipe group and 616 in the no wipe group. Maternal demographics were similar between patient groups (NS). Intrapartum factors including gestational age at time of Cesarean section, type of anesthesia used for the operative delivery, hours of amnion rupture prior to delivery, use of internal monitoring devices, type of skin incision, method of placental removal, total operative time and estimated blood loss were similar between patient groups (NS). An almost identical number of patients in each arm of the study developed post-Cesarean endometritis (65 out of 614, 10.5%, in the uterine wipe group vs. 66 out of 616, 10.7%, in the no wipe group; p 1). CONCLUSIONS: Both methods of removing residual amnion-chorion membrane tissue and associated debris at surgery were comparably effective, but neither produced a dramatic reduction in the incidence of postoperative endometritis. Ashley At Fri, 5 May 2006, Raymond Stephen wrote: > >Just reminds me how nervous I get when I see a new registrar digging >around for what seems like 25 minutes with a large abdominal pack >tearing the decidua from the myometrium and enlarging the uterine >incision into the bargain. If it is not necessary at vaginal delivery >why should it be necessary at Caesar. A quick check with a finger or >two is enough. My question is "what debris?" > >Steve > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod, >Darryl G Maj 48 MDOS/SGOBO >Sent: Thursday, 4 May 2006 4:44 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: no subject received Wed, 3 May 2006 09:02:42 -0500 > >I particularly like the "uterus was exteriorized and cleared of all clot >and debris" since that is the direct quote I learned and use from the >little red book we all got in residency. > >Has anyone ever seen something similar with vaginal delivery??? > >Glen Next message: Joanne Bulley, MD: "Re: cesarean art" Previous message: Raymond Stephen: "Re: quadruplet" In reply to: Raymond Stephen: "Re: "cleared of all clot and debris" - was: no subject received Wed, 3 May 2006 09:02:42 -0500" Next in thread: Dr Eberhard W Lisse: "Re: 'cleared of all clot and debris' - was: no subject received Wed, 3 May 2006 09:02:42 -0500"

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