Hawrylyshyn P A, Bernstein P, Papsin F R
Am J Obstet Gynecol. 1981 Feb 1;139(3):294-8. doi: 10.1016/0002-9378(81)90013-2.
A retrospective study by means of multivariant discriminant analysis was performed on 496 deliveries (250 vaginal and 246 cesarean sections) is identify risk factors which predispose to postoperative febrile morbidity, in particular, endometritis. The infection rates for endometritis by type of delivery were: vaginal, 3.6%; elective repeat cesarean section, 6.0%; nonurgent primary cesarean section, 22.2%; and emergency cesarean section, 38.4%. No patient-related risk factors were identified for elective repeat cesarean section, and bacterial isolates were most frequently Staphylococcus aureus. However, four statistically significant risk factors were associated with the occurrence of endometritis after primary cesarean section. In increasing order of significance, they were duration of labor, number of preoperative vaginal examinations, time membranes were ruptured prior to delivery, and postoperative anemia. Internal fetal monitoring was not a risk factor. The clinical relevance of these findings to the use of prophylactic antibiotics and other attempts aimed at decreasing postoperative morbidity is discussed.
通过多变量判别分析对496例分娩（250例阴道分娩和246例剖宫产）进行了一项回顾性研究，以确定易导致术后发热性疾病尤其是子宫内膜炎的危险因素。不同分娩方式的子宫内膜炎感染率分别为：阴道分娩3.6%；择期再次剖宫产6.0%；非紧急初次剖宫产22.2%；急诊剖宫产38.4%。未发现择期再次剖宫产有与患者相关的危险因素，且分离出的细菌最常见的是金黄色葡萄球菌。然而，有四个具有统计学意义的危险因素与初次剖宫产后子宫内膜炎的发生有关。按重要性递增顺序排列，它们依次是产程持续时间、术前阴道检查次数、分娩前胎膜破裂时间和术后贫血。胎儿宫内监测不是危险因素。本文讨论了这些发现对于预防性使用抗生素及其他旨在降低术后发病率的措施的临床意义。
