Chlamydia trachomatis isolation in patients with endometritis after cesarean section

doi:10.1016/S0002-9378(85)80209-X

American Journal of Obstetrics and Gynecology

Volume 152, Issue 3, 1 June 1985, Pages 278-279

https://doi.org/10.1016/S0002-9378(85)80209-X Get rights and content

Cervical specimens for Chlamydia were collected from 110 patients with endometritis after cesarean section and from 52 intrapartum patients without clinical infection. The C. trachomatis isolation rate was not statistically different between these groups.

References (3)

GP Wager et al.
Puerperal infectious morbidity: relationship to route of delivery and to antepartum Chlamydia trachomais infection
Am J Obstet Gynecol
(1980)

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Cited by (11)

Treatment of Sexually Transmitted Infections in Women
2008, Infectious Disease Clinics of North America
Citation Excerpt :
Untreated maternal cervical chlamydial infection, however, is associated with an increased risk for preterm delivery, premature rupture of the membranes, and possibly perinatal mortality [57]. Infection with chlamydia does not seem to be associated with an increased risk for chorioamnionitis or with pelvic infection after cesarean delivery [58]. The CDC recommends screening at the first prenatal visit and again in the third trimester for women less than 25 years old or those who have new or multiple sex partners [8].
Sexually transmitted infections remain a major public health concern in the United States. An estimated 19 million infections occur each year. The economic burden imposed by sexually transmitted infections is impressive: direct medical costs are estimated to be as high as $15.5 billion annually. Women and infants disproportionately bear the long-term consequences of sexually transmitted diseases. This article briefly introduces various infections, reviews new diagnostic information, and presents the latest guidelines for therapy. All recommended and alternative regimens are drawn from the most recent Centers for Disease Control and Prevention treatment guidelines and recent updates.
Treatment of sexually transmitted infections in pregnancy
2005, Clinics in Perinatology
Bacterial, Fungal, and Parasitic Disease
2004, Medical Complications During Pregnancy
10 Infection due to Chlamydia trachomatis in pregnancy and the newborn
1993, Bailliere's Clinical Obstetrics and Gynaecology
Bacteria in the genus Chlamydia comprise three species, C. trachomatis, C. psittaci and C. pneumoniae. C. trachomatis infection is common, varying in prevalence in women from 0% to 37%. In the United States, the prevalence rate is estimated currently to be about 5%. Pregnancy may predispose to an increased chance of infection with C. trachomatis, through physiological immunosuppression and/or cervical ectopy. Maternal antibodies to C. trachomatis provide limited, if any, protection for the newborn.
C. trachomatis causes pelvic inflammatory disease—which can result in tubal infertility or ectopic pregnancy and postabortal or late postpartum endometritis. It may also cause chorioamnionitis and premature delivery of the fetus. The incidence of vertical transmission of chlamydiae from mother to baby varies; if the mother is untreated, 20–50% of the newborns will develop conjunctivitis and 10–20% will develop pneumonia.
C. psittaci infection in pregnancy is rare, but can cause spontaneous abortion. Whether C. pneumoniae infection in pregnancy has any influence on the outcome has not been ascertained.
C. trachomatis can be detected by one or more of several methods; enzyme immunoassays are the least sensitive, but the most widely used. Screening for C. trachomatis in pregnancy may be of benefit in areas of high prevalence, and is generally regarded as being cost-effective if the prevalence rate is more than 5%.
Pregnant women are best treated with erythromycin, 250 mg four times daily for 7 days. This will prevent infection of the newborn in more than 90% of cases. The infected neonate should be treated with erythromycin, given systemically and also with topical tetracycline if conjunctivitis is present.
Chlamydia trachomatis infection during pregnancy
1991, American Journal of Obstetrics and Gynecology
Although transmission of Chlamydia trachomatis to infants during vaginal birth can result in conjunctivitis and pneumonitis, there is uncertainty about other adverse effects of chlamydial infection during pregnancy. There is some evidence that it may contribute to adverse complications such as premature rupture of membranes, preterm labor and birth, low birth weight, and still birth. Infection with C. trachomatis is also implicated in postabortal, postcesarean section, and postpartum maternal infections. Treatment of chlamydial infection during pregnancy has proved beneficial in the prevention of neonatal morbidity and is now recommended by the Centers for Disease Control.
Risk factors for fever, endometritis and wound infection after abdominal delivery
1989, International Journal of Gynecology and Obstetrics
Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). The only significant risk factors for endometritis were amnionitis (relative risk = 8.7), postoperative hematoma (relative risk = 5.0) and age under 24 years (relative risk = 3.0). Wound infections were less frequent in cases with previous cesarean sections (relative risk = 0.15) and after elective cesarean sections (relative risk = 0.22), but duration of operation over 1 h (relative risk = 2.8), induction of labor (relative risk = 3.2) and puerperal endometritis (relative risk = 7.9) increased the risk of wound infection. By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.

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: Informed consent was obtained from patients, and guidelines for human experimentation of the author's institution were followed in the conduct of this research.

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American Journal of Obstetrics and Gynecology

References (3)

Puerperal infectious morbidity: relationship to route of delivery and to antepartum Chlamydia trachomais infection

Am J Obstet Gynecol

Cited by (11)

Treatment of Sexually Transmitted Infections in Women

Treatment of sexually transmitted infections in pregnancy

Bacterial, Fungal, and Parasitic Disease

10 Infection due to Chlamydia trachomatis in pregnancy and the newborn

Chlamydia trachomatis infection during pregnancy

Risk factors for fever, endometritis and wound infection after abdominal delivery