The time for postpartum sterilization: Report of 150 cases bacteriologic studies on the postpartum uterus

Abstract

The performance of early postpartum sterilization on nonfebrile patients has already stood the test of time. A group of early postpartum sterilizations from the Peiping Union Medical College, Peking, China, and the University of Tennessee College of Medicine, Memphis has been reported with studies on the bacteriology of the puerperal uterus. Studies on the normal postpartum uterus show that bacterial invasion occurs soon after delivery. It is clear that in many instances it might be necessary to wait a few hours after delivery before such a procedure is undertaken, but if the patient's condition is such that one should wait many hours, it is questionable as to whether it should be done at all, and certainly not after the first day. These bacteriologic studies also support the well-known clinical fact that the removal of membranes or fragments of placental tissue from the uterus shortly after delivery is relatively safe, whereas, the same procedure after the first postpartum day may be a dangerous intervention. With the patient in good condition, she is better protected by carrying out such a procedure in the early postpartum period. The optimum time to perform postpartum sterilization is from one to two hours after spontaneous delivery, which means that the period of probable postpartum hemorrhage is over, and the period of probable infection has not yet begun.