Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California.
Am J Perinatol. 2019 Oct;36(12):1211-1215. doi: 10.1055/s-0039-1683888. Epub 2019 Mar 20.
To evaluate whether prophylactic antibiotics at the time of placement of an intrauterine balloon tamponade (IBT) is associated with a reduction in postpartum endometritis.
Retrospective cohort study of patients who received an IBT from January 1, 2012, to December 12, 2016. Patients were included if the IBT remained in place at least 2 hours and excluded if chorioamnionitis was present. Patients who received prophylactic antibiotics at the time of IBT placement were compared with those who did not.
A total of 149 subjects received an IBT; 36 were excluded due to early removal or chorioamnionitis. Of the remaining, 59 received prophylactic antibiotics and 54 did not. Baseline characteristics were similar between the groups except mode of delivery. The majority (65%) of those who did not receive prophylactic antibiotics had a cesarean delivery ( = 0.03). The overall incidence of endometritis was 15%. The incidence of endometritis was greater among those patients who did not receive prophylactic antibiotics compared with those who did (5 vs. 26%; < 0.002; odds ratio [OR]: 6.53; 95% confidence interval [CI]: 1.76-24.25). This association remained after adjustment for mode of delivery and receiving group B antibiotics prior to delivery (adjusted OR: 5.9; 95% CI: 1.58-22.35).
Prophylactic antibiotics were associated with a reduction in postpartum endometritis among patients receiving an IBT.
评估在放置宫腔内球囊压迫（IBT）时预防性使用抗生素是否与降低产后子宫内膜炎的风险有关。
这是一项回顾性队列研究，纳入了 2012 年 1 月 1 日至 2016 年 12 月 12 日期间接受 IBT 的患者。纳入标准为 IBT 至少留置 2 小时，排除标准为存在绒毛膜羊膜炎。将接受 IBT 时预防性使用抗生素的患者与未接受预防性使用抗生素的患者进行比较。
共 149 例患者接受了 IBT；36 例因过早移除或绒毛膜羊膜炎而被排除。在剩余的患者中，59 例接受了预防性抗生素治疗，54 例未接受。两组患者的基线特征相似，除分娩方式外。未接受预防性抗生素治疗的患者中，多数（65%）为剖宫产（ = 0.03）。子宫内膜炎的总发生率为 15%。与未接受预防性抗生素治疗的患者相比，接受预防性抗生素治疗的患者子宫内膜炎的发生率更高（5% vs. 26%； < 0.002；优势比[OR]：6.53；95%置信区间[CI]：1.76-24.25）。在调整分娩方式和分娩前使用 B 组抗生素后，这种相关性仍然存在（调整后的 OR：5.9；95% CI：1.58-22.35）。
在接受 IBT 的患者中，预防性使用抗生素与降低产后子宫内膜炎的风险有关。
