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PubMed1988

A prospective study of postpartum psychoses in a high-risk group. 6. Relationship to birth complications and neonatal abnormality.

Somatic complications of labor and delivery and offspring abnormality were studied in relationship to the development of 24 postpartum psychotic episodes (PPPs) occurring among index women with a history of nonorganic psychosis. The 24 PPP cases were compared with 60 index cases not developing PPPs. Nonsignificant trends were found towards increased rates of induction of labor, fetal distress, instrumental deliveries and offspring abnormality among cases with PPP onset within 3 weeks of delivery. Instrumental delivery was the only complication that tended to have occurred with increased frequency among cases with PPP onset after 3 weeks.

Adaptation, Psychological↗
PubMed1998

Chorioamnionitis: is continuation of antibiotic therapy necessary after cesarean section?

OBJECTIVE: Our purpose was to determine whether the continuation of antibiotics postoperatively after cesarean section in patients whose labors were complicated by chorioamnionitis would reduce the incidence of endometritis. STUDY DESIGN: Patients with a clinical diagnosis of chorioamnionitis treated with ampicillin during labor and who required cesarean delivery for obstetric indications received preoperative intravenous clindamycin and gentamicin and were randomized into 2 groups. Group 1 received no scheduled postoperative antibiotics and group 2 continued to receive clindamycin 900 mg every 8 hours and gentamicin 1.5 mg/kg every 8 hours until afebrile for a minimum of 24 hours (temperature </=100 degreesF). RESULTS: Sixty-one patients were randomized to group 1 and 55 patients were randomized to group 2. The duration of labor, the duration of membrane rupture, and the number of intrapartum vaginal examinations were statistically insignificant between the 2 groups. The mean duration of maternal postoperative hospital stay was 4 days for both groups. There were no statistically significant differences in the rate of endometritis for group 1, 9 of 61 (14.8%), versus group 2, 12 of 55 (21.8%), P =.32. CONCLUSIONS: In patients whose labors were complicated by chorioamnionitis and who underwent cesarean section, the continuation of preoperative clindamycin and gentamicin in the postoperative period did not reduce the risk of endometritis compared with a single preoperative dose.

Adult↗