Risk Of Endometritis Research Articles

Use of osmotic dilators to facilitate induced midtrimester abortion: Clinical evaluations

A number of studies evaluating an osmotic cervical dilator consisting of polyvinyl foam saturated with magnesium sulphate in women undergoing midtrimester abortion with intra-amniotic hyperosmolar urea plus prostaglandin F2a were completed. Comparisons with women receiving no pre-treatment with a laminaria tent or with one laminaria indicate that their use appears to shorten injection-abortion intervals, particularly in parous women, and reduce risk of endometritis and cervical laceration compared to women not receiving any type of device. The data suggests that two osmotic dilators may be more effective than one. Also, magnesium toxicity does not appear to be a substantial risk with their use.

REGENERATION OF THE HUMAN ENDOMETRIUM AND PRESENCE OF INFLAMMATORY CELLS FOLLOWING DIAGNOSTIC CURETTAGE

The regeneration of the human endometrium, with particular emphasis on the presence of inflammatory cells, was studied in 106 women undergoing hysterectomy following curettage. The interval between the last curettage and the hysterectomy varied from 1 day to 12 months. A slight but significant increase in the number of neutrophil cells was observed during the first 7 days after the curettage in proliferating endometrium. This increase was considered to reflect the regeneration phenomenon rather than a true infection. No statistically significant increase in the number of neutrophils and mononuclear cells was observed after the first week following the curettage. The study does not provide any evidence that the introduction of a curette or a suction instrument in the uterine cavity increases the risk of endometritis.

Clinical Risk Factors for Puerperal Infection

Recent studies have identified clinical features that are major risk factors for puerperal infection. Patients of low socioeconomic status undergoing cesarean section who have had prolonged labor and rupture of membranes (ROM) incur a 40 to 85% risk of endometritis. Infection occurs generally in less than 10% of women undergoing vaginal delivery, even when complicated by prolonged ROM, and often in considerably fewer cases. Other features such as internal monitoring, obesity, anemia, and general anesthesia have not been consistent determinants in recent studies.

Evaluation of a balloon dilator before second-trimester abortion by vacuum curettage

We evaluated the cervical dilator device (CDD), an expanding balloon, as a substitute for laminaria tents before abortion at 13 to 16 1/2 weeks by extraction and vacuum curettage. The CDD was found to be an effective dilator, although it did not appear to have any advantage over laminaria tents when placed overnight and was associated with significant pain upon insertion and an apparent increased risk of endometritis. The present CDD or a subsequent modification may offer advantages over laminaria tents for short-term placement.

The relationship of immediate post-abortal intrauterine device insertion to subsequent endometritis: A case-control study

A case-control study examining the risk for post-abortal endometritis in patients undergoing an immediate intrauterine device insertion after suction curettage for first trimester elective abortion was completed. The relative risk for endometritis in patients receiving the Dalkon Shield and Lippes Loop respectively was 0.56 and 0.33 when endometritis cases were matched with suitable controls. The significance of this finding and possible sources of bias are discussed.

Untreated endocervical gonorrhea and endometritis following elective abortion

A matched-pair analysis of 228 cases of endometritis occurring over a two-year period in 4,823 elective abortion patients was carried out. Patients with postabortal endometritis were matched with control subjects for age, parity, race, pay status, time of abortion, and type of abortion procedure. The prevalence of endocervical gonorrhea was 2.7 per cent in the entire group seeking abortion, with 14.7 per cent of patients with gonorrhea subsequently developing endometritis. The matched-pair analysis detected a threefold increased risk for endometritis in patients with untreated gonoccocal endocervicitis when compared with control subjects (p < 0.05). The significance of these findings to centers performing abortions is discussed.