UW postpartum endometritis + incision infect 02-21 (1)

Question 1

UW. table. Risk factors? 5

Answer 1

S/c - MCC
Intraamniotic infection
Group B strep colonization
Prolonged rupture of membranes
Operative vaginal delivery

Question 2

UW. table. CP? 3

Answer 2

fever > 24h postpartum
Uterine fundal tenderness
Purulent lochia

Question 3

UW. table. Etiology?

Answer 3

polymicrobal infection

Question 4

UW. table. Tx? abs

Answer 4

Clindamycin + gentamicin

Question 5

UW. postpartum endometritis yra infection of what?

Answer 5

infection of the uterine decidua and the most common etiology of puerperal fever.

Question 6

UW. most common etiology of puerperal fever?

Answer 6

postpartum endometritis

Question 7

UW. CP!! Fever + purulent lochia + uterine tenderness

Answer 7

.

Question 8

UW. Postpartum endometritis is the result of inoculation of the uterine cavity by vaginal flora during labor or delivery.

Answer 8

.

Question 9

UW. Normal vaginal flora includes a mix of? 3

Answer 9

gram-positive cocci (eg, group B Streptococcus [GBS]), gram-negative bacilli (eg, Escherichia coli), and anaerobes (eg, Gardnerella vaginalis);

Question 10

UW. plymicrobal => broad spectrum abs.

Answer 10

A common regimen is clindamycin plus gentamicin; clindamycin covers gram-positives and anaerobes,
and gentamicin covers gram-negative bacilli.

Question 11

UW. how long give Tx abs?

Answer 11

continued until the patient is afebrile for >24 hours

Question 12

UW. do we need to take culture to evaluate Tx?

Answer 12

Neither blood nor endometrial cultures are required for diagnosis

Question 13

UW. in what case need further evaluation, eg blood/endometrial cultures?

Answer 13

if there is no clinical improvement after 48 hours of antibiotic therapy.

Question 14

UW. major risk factor?

Answer 14

cesarean delivery because it can introduce both microbial organisms (eg, skin flora) and foreign bodies (eg, suture) into the uterus.

In addition, suture repair of the uterine incision can cause necrosis of the myometrial tissue, which may serve as a nidus for infection.

Question 15

UW. kodel butent EMERGENCY s/c yra risk factor?

Answer 15

due to the added risks of inadequate skin antisepsis and missed antibiotic prophylaxis under emergency conditions.

Question 16

UW. to decr risk = give abs preoperatively

Answer 16

can be decreased with administration of routine preoperative antibiotics (eg, cefazolin) 30 minutes prior to skin incision.

Question 17

UW. postpartum endometritis vs catheter UTI?

Answer 17

Although early catheter discontinuation (eg, on postoperative day 2) is recommended to prevent catheter-associated urinary tract infection, earlier catheter removal would not have prevented this patient’s postpartum endometritis (fever, fundal tenderness).

tiesiog nera gimdos tenderness :D

Question 18

UW. incision skin infection. CP? onset?

Answer 18

Surgical site infection within days to weeks after surgery.

Question 19

UW. incision skin infection. CP?

Answer 19

Postpartum fever (≥38 C more than 24 hours after delivery), wound induration, and incisional erythema most likely has cellulitis, a superficial surgical site infection

Question 20

UW. incision skin infection. risk factor?

Answer 20

emergency S/c, because sterile procedure might be violated, also, due to emergency lack of preop. antibiotics

Question 21

UW. incision skin infection.Tx?

Answer 21

Nononpurulent cellulitis = first-generation cephalosporins (eg, cephalexin) because they cover common skin pathogens (eg, beta-hemolytic streptococci, MSSA