Intrauterine cleaning after placental delivery at cesarean section: a randomized controlled trial

Ahizechukwu Eke, Sheila Drnec, Andrea Buras, Joanna Woo, Denny Martin, Steven Roth

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study is to evaluate whether omission of intrauterine cleaning increases intraoperative and postoperative complications among women who deliver via cesarean section. Methods: We randomized 206 women undergoing primary elective cesarean deliveries to intrauterine cleaning or omission of cleaning. Postpartum endomyometritis rates across groups were the primary outcome. We also examined secondary outcomes. To detect a 20% difference in infection rate between the cleaned and the non-cleaned groups (two-tailed [alpha] = 0.05, [beta] = 0.2), 103 women were required per group. Analysis was by intention-to-treat. Results: Two hundred and six were randomized as follows: 103 to intrauterine cleaning and 103 to omission of cleaning after placental delivery. There were no statistically significant differences in the rate of endomyometritis between the two groups (2.0% versus 2.9%, RR =0.60; 95% CI 0.40–1.32). There were no statistically significant differences in postpartum hemorrhage rates (5.8% versus 7.7%, RR 0.75; 95% CI 0.6–1.2), hospital readmission rates (2.9 versus 3.8%, RR 0.75; 95% CI 0.5–1.6), time to return of gastrointestinal function, need for repeat surgery, or quantitated blood loss between the two groups. Conclusions: Our randomized controlled trial provides evidence suggesting that omission of intrauterine cleaning during cesarean deliveries in women at low risk of infection does not increase intraoperative or postoperative complications.

Original languageEnglish (US)
Pages (from-to)236-242
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume32
Issue number2
DOIs
StatePublished - Jan 17 2019

Fingerprint

Cesarean Section
Randomized Controlled Trials
Endometritis
Intraoperative Complications
Patient Readmission
Postpartum Hemorrhage
Intention to Treat Analysis
Infection
Reoperation
Postpartum Period

Keywords

  • cesarean section
  • endomyometritis
  • Intrauterine cleaning
  • placental delivery
  • randomized trial

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Intrauterine cleaning after placental delivery at cesarean section : a randomized controlled trial. / Eke, Ahizechukwu; Drnec, Sheila; Buras, Andrea; Woo, Joanna; Martin, Denny; Roth, Steven.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 32, No. 2, 17.01.2019, p. 236-242.

Research output: Contribution to journalArticle

Eke, Ahizechukwu ; Drnec, Sheila ; Buras, Andrea ; Woo, Joanna ; Martin, Denny ; Roth, Steven. / Intrauterine cleaning after placental delivery at cesarean section : a randomized controlled trial. In: Journal of Maternal-Fetal and Neonatal Medicine. 2019 ; Vol. 32, No. 2. pp. 236-242.
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abstract = "Objective: The objective of this study is to evaluate whether omission of intrauterine cleaning increases intraoperative and postoperative complications among women who deliver via cesarean section. Methods: We randomized 206 women undergoing primary elective cesarean deliveries to intrauterine cleaning or omission of cleaning. Postpartum endomyometritis rates across groups were the primary outcome. We also examined secondary outcomes. To detect a 20{\%} difference in infection rate between the cleaned and the non-cleaned groups (two-tailed [alpha] = 0.05, [beta] = 0.2), 103 women were required per group. Analysis was by intention-to-treat. Results: Two hundred and six were randomized as follows: 103 to intrauterine cleaning and 103 to omission of cleaning after placental delivery. There were no statistically significant differences in the rate of endomyometritis between the two groups (2.0{\%} versus 2.9{\%}, RR =0.60; 95{\%} CI 0.40–1.32). There were no statistically significant differences in postpartum hemorrhage rates (5.8{\%} versus 7.7{\%}, RR 0.75; 95{\%} CI 0.6–1.2), hospital readmission rates (2.9 versus 3.8{\%}, RR 0.75; 95{\%} CI 0.5–1.6), time to return of gastrointestinal function, need for repeat surgery, or quantitated blood loss between the two groups. Conclusions: Our randomized controlled trial provides evidence suggesting that omission of intrauterine cleaning during cesarean deliveries in women at low risk of infection does not increase intraoperative or postoperative complications.",
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