Effects of placental delivery method and intraoperative glove changing on postcesarean febrile morbidity.

Abstract

This study was designed to evaluate the effects of the placental delivery methods and intraoperative glove changing on postcesarean febrile morbidity. In this randomized controlled trial, consenting patients were randomized to one of four management protocols: Group A (n = 26)--no glove change with manual placental delivery; Group B (n = 27)--no glove change with expressed placental delivery; Group C (n = 27)--glove change with manual placental delivery; and Group D (n = 28)--glove change with expressed placental delivery. Glove change was performed by removal of a second glove after delivery of the fetal head. Variables examined included febrile morbidity, endometritis, maximums and durations of elevated temperatures, as well as other demographic, intrapartum, and postpartum variables. Febrile morbidity and endometritis rates were not significantly different between the four groups. When the groups were combined so as to compare no glove change versus glove change (Groups A and B vs. C and D) and manual versus expressed placental delivery (Groups A and C vs. B and D), there were no significant differences in either febrile morbidity (relative risk: 0.7, 95% CI: 0.3-1.4 and relative risk: 1.4, 95% CI: 0.6-3.5) or endometritis (relative risk: 1.2, 95% CI: 0.5-2.8 and relative risk: 1.5, 95% CI: 0.6-3.6), respectively. There were no statistically significant differences in measures of postcesarean febrile morbidity based on placental delivery method or intraoperative glove change.