Assessing the Risk of Developing Endometritis for Postpartum Mothers After an Emergency C-Section at Prisma Health Richland Hospital

Cheyenne Hammond, Dr. Matthew Lenhard, Dr. James Cook, Dr. Kamla Sanasi

Introduction
Endometritis, or endomyometritis describes an ascending infection of the endometrium often by abnormal exposure to cervicovaginal microflora. This post-operative complication is most commonly seen in women who have undergone a cesarean delivery. The risk for infection is even higher for those women who have an unplanned cesarean after failed labor and exposure through ruptured membranes. For those 5 to 10 percent that do not respond to treatment it could be indicative of a more serious complication such as septic pelvic vein thrombophlebitis, pelvic abscess, or wound infection. Reducing the incidence of this disease not only affects the immediate health outcome of the mother, it also has the potential to reduce the chance of a complication in a future pregnancy and delivery. (Shipp, Zelop, Cohen, Repke, & Lieberman, 2003). This retrospective study looks at a year’s worth of data for postpartum mothers at Prisma Health Richland hospital to determine what the current rates of endometritis infection are and what demographic data is associated with them.

Methods
Inclusion Criteria: Patients who were greater than 16 years old, greater than 37 weeks gestation, in labor and underwent cesarean section, and/or treated within 8 weeks of delivery for endometritis were included in the data. 

Exclusion Criteria: Patients who were less than 16 years old, less than 37 weeks gestation, had a planned cesarean section, had preterm pre-labor rupture of membranes, had preoperative fevers or chorioamnionitis, and/or known allergy to povidone iodine or shellfish were excluded in the data. 

Results
Total with Endometritis= 7.5%
Average BMI= 37.55 
Average Hospital Length of Stay=15 days
# with manual removal of placenta= 94%
# with Diabetes= 25%

Discussion 

The next phase of this study involves gathering additional data to improve analysis, as well as implementing vaginal iodine cleansing in the hospital setting to determine if it results in a significant change in endometritis morbidity. 
 

© 2020 by The UofSC SOM Research Center for Transforming Health

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