Puerperal endometritis and intrauterine fetal heart rate monitoring.

The incidence of puerperal endometritis in 5058 patients who were delivered during a one year study period was recorded prospectively. Caesarean section was performed in 774 cases (15.3%) and intrauterine fetal heart rate monitoring was used in 2016 cases (39.9%). After vaginal delivery, the incidence of endometritis was 1.5% in those monitored externally and 2.4% in those monitored internally (P less than 0.05). After Caesarean section, endometritis occurred in 8.0% of those monitored externally and in 16.4% of those monitored internally for varying times (P less than 0.01). The duration of monitoring had no significant effect on these infection rates. The risk of puerperal endometritis after internal fetal monitoring seemed to be the same as after one vaginal examination.