Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
J Obstet Gynaecol Res. 2021 Apr;47(4):1330-1336. doi: 10.1111/jog.14658. Epub 2021 Jan 12.
The aim of the study was to compare the rates of postpartum endometritis due to uterine cleaning and no cleaning in patients delivered by elective cesarean section.
This was a randomized clinical trial conducted at the Obstetrics and Gynecology Department, Suez Canal University Hospital, Ismailia, from June 2019 to November 2019. We recruited patients undergoing cesarean delivery aged 18-45 years with singleton pregnancy, intact membranes, either first or repeated delivery, without labor pains. Patients were allocated into two groups, uterine cleaning (336 patients) and no cleaning (312 patients). The main outcome measure was the occurrence of postpartum endometritis.
Both groups were matched in their demographic characters. Twelve patients (3.6%) developed endometritis in the cleaning group versus one patient (0.3%) in the other one. Estimated blood loss was 754.35 ± 247.13 and 730.36 ± 232.77 for the cleaning and no cleaning groups, respectively, with a P value of 0.201. Septic wound infection (21 patients, 6.3%) was predominant in the cleaning group.
Uterine cleaning after delivery of the placenta during CS can be omitted as a surgical step during the operation. It was associated with increased rates of postpartum endometritis and blood loss.
本研究旨在比较选择性剖宫产术中行子宫清理与不清理患者的产后子宫内膜炎发生率。
这是 2019 年 6 月至 11 月在伊斯梅利亚苏伊士运河大学医院妇产科进行的一项随机临床试验。我们招募了年龄在 18-45 岁、单胎妊娠、胎膜完整、初产妇或经产妇、无宫缩的剖宫产患者。患者被分为两组，子宫清理组（336 例）和不清理组（312 例）。主要观察指标为产后子宫内膜炎的发生情况。
两组的人口统计学特征相匹配。清理组中有 12 例（3.6%）发生子宫内膜炎，而不清理组中有 1 例（0.3%）。清理组和不清理组的估计失血量分别为 754.35±247.13 和 730.36±232.77，P 值为 0.201。清理组中以感染性伤口（21 例，6.3%）为主。
剖宫产术中胎盘娩出后可省略子宫清理这一手术步骤。它与产后子宫内膜炎和出血量增加有关。
