Amniotomy and postpartum endometritis: a case-control study

Abstract

OBJECTIVE

To assess the whether amniotomy is the risk for postpartum endometritis.

METHODS

This is a case-control study to identify risk factors for postpartum endometritis in patients underwent vaginal delivery. Cases were patients who had postpartum endometritis after vaginal delivery, including spontaneous vaginal delivery or assisted vaginal delivery between 2010 and 2014 at Khon Kaen Hospital. Each case was matched to four controls for age and parity on consecutive delivery. Controls were patients who had vaginal delivery including spontaneous vaginal delivery or assisted vaginal delivery but were not diagnosed as postpartum endometritis.

RESULTS

We selected 46 cases and 184 age and parity matched controls. There was no association between amniotomy and postpartum endometritis (crude odds ratio [COR], 1.55; 95% confidence interval [CI], 0.81 to 2.96, adjusted odds ratio [AOR], 1.71; 95% CI, 0.61 to 4.76). Retained piece of placenta (COR, 35.86; 95% CI, 7.73 to 166.25; AOR, 19.75; 95% CI 2.10 to 186.12), postpartum hemorrhage (COR, 48.53; 95% CI, 10.62 to 221.88; AOR, 101.03; 95% CI 7.54 to 1353.14) and body mass index (BMI)≥30 (COR, 3.78; 95% CI, 0.796 to 18.13, AOR, 9.18; 95% CI, 1.11 to 76.08) were the three factors that increased the risk for postpartum endometritis.

CONCLUSION

Our study found that amniotomy was not significantly associated with the occurrence of postpartum endometritis but retained piece of placenta, postpartum hemorrhage, and BMI≥30 increased the occurrence of postpartum endometritis were associated with higher risk of postpartum endometritis.