Libombo A, Folgosa E, Bergström S
Department of Obstetrics and Gynaecology, Central Hospital, Maputo, Mozambique.
Gynecol Obstet Invest. 1995;39(3):180-5. doi: 10.1159/000292404.
Post-caesarean endometritis-myometritis (PCEM) was diagnosed in 49 Mozambican women. They were compared with 47 control women without signs of PCEM after caesarean section. The patients and controls were matched for age, parity and days post partum. Features of the socio-economic background and of past and current obstetric history were registered. Endocervical, intracavitary and blood cultures were carried out. Screening for syphilis seropositivity and HIV-1 and HIV-2 antibodies was performed. Socio-economic and obstetric background factors were similarly distributed in cases and referents, though previous caesarean section was less frequent among cases than among referents (OR 0.12). Moderate high-risk factors in existing antenatal card tended to be more frequent among cases than among referents (OR 3.29). Microbiological findings indicated more anaerobes in the vagina, in the endocervix and in the uterine cavity, though the differences only approached significance. It is concluded that women with PCEM in the setting studied expose few characteristic background features discriminating them from women with uneventful post-caesarean outcome. Further research efforts should be directed towards case-control studies with focus upon surgical factors and on a more comprehensive microbiology and serology approach.
49名莫桑比克女性被诊断为剖宫产术后子宫内膜炎-子宫肌炎（PCEM）。将她们与47名剖宫产术后无PCEM体征的对照女性进行比较。患者和对照在年龄、产次和产后天数方面进行了匹配。记录了社会经济背景以及既往和当前产科病史的特征。进行了宫颈管、宫腔和血培养。进行了梅毒血清阳性以及HIV-1和HIV-2抗体的筛查。病例组和对照组的社会经济和产科背景因素分布相似，不过病例组既往剖宫产的频率低于对照组（比值比0.12）。现有产前检查记录中的中度高危因素在病例组中往往比对照组更常见（比值比3.29）。微生物学检查结果显示，阴道、宫颈管和宫腔中的厌氧菌更多，不过差异仅接近显著水平。得出的结论是，在所研究的环境中，患有PCEM的女性几乎没有可将她们与剖宫产术后结局正常的女性区分开来的特征性背景特征。进一步的研究工作应针对病例对照研究，重点关注手术因素以及更全面的微生物学和血清学方法。
