Bacteriology of the uterus at cesarean section

Abstract

1.1. In a report from Johns Hopkins Hospital, 44 per cent positive uterine cultures were found without the use of instillations.2.2. In our series, 4.1 per cent positive uterine cultures were obtained with the routine use of acriflavine instillations.3.3. The importance of anaerobic organisms as the chief contaminants is stressed.4.4. With the use of antiseptic instillations the period of time in labor may be greatly prolonged with negative cultures being obtained as late as 107½hours after the onset of labor.5.5. Intra-partum infection may be present on admission and vaginal instillations are too late to be of real value.6.6. Among the patients cultured there was one death which resulted from hemorrhage.7.7. Fifty-two and five-tenths per cent of the patients who had cesarean sections were cultured.8.8. Of the 6 positive cultures, 5 were not elective cases.9.9. Thirty-five cases were not elective and only five of these patients had positive cultures (14 per cent).10.10. Positive cultures can be obtained with membranes intact.11.11. The morbidity in this series was 52.8 per cent.12.12. Three deaths from puerperal infection occurred during the first year of the study.13.13. Instillations should be given prophylactically twice daily on waiting cases and every four hours if in labor.