BACKGROUND: Various operative procedures and techniques have been made in attempts to diminish the incidence of postoperative wound infection. The use of two surgical knives was found to have no correlation to wound infection in several orthopedic-related surgeries. No studies, however, could be found on the effects of using such technique in cesarean section. The purpose of this study is to determine whether the use of different surgical blades for skin cutting and deep tissue incision decrease the incidence of post-cesarean infectious morbidity.
METHODS: A total of 190 obstetric patients admitted for scheduled or nonscheduled cesarean section were randomly assigned to two groups by sealed number envelopes. The first group was composed of patients who used only one blade for skin and deep tissue incision. The second group used separate blades. Patients from both groups were assessed days 0 to 2 post-cesarean and 2-4 weeks after (on follow-up). The temperature pattern post-operative was monitored as well as presence of wound discharge, foul-smelling vaginal discharge, persistent abdominal pain, and persistent fever that may indicate surgical site infection, postpartum endometritis, and pelvic abscess. Statistical analysis was performed using the Fisher's Exact test.
RESULTS: Nineteen (11.3%) of 168 patients had superficial surgical site infection, 11 (13.3%) from the single blade group, compared with 8 (9.4%) from the double blade group. The difference between the two groups was not statistically significant (p=0.29). None of the patients developed deep incisional or organ space surgical site infection, endometritis, or pelvic abscess post-cesarean. There was also no significant difference for the two groups in temperature pattern and presence of wound discharge or wound dehiscence.
CONCLUSION: The use of different surgical blades for skin cutting and deep tissue incision does not show to decrease post-cesarean infectious morbidity. It is unnecessary to use two knives for surgical incisions in cesarean section.

Human ; Female ; Adult ; Pregnancy ; Surgical Wound Infection ; Endometritis ; Surgical Wound ; Abscess ; Temperature ; Puerperal Infection ; Cesarean Section ; Morbidity ; Vaginal Discharge ; Abdominal Pain ; Postpartum Period

OBJECTIVE: This randomized, single-blind, two-arm controlled study compared the efficacy, safety, and tolerability of an intravaginal suppository preparation containing metronidazole 750mg + miconazole 200mg (Neopenotran Forte) with another vaginal preparation containing metronidazole 500 mg + nystatin 10000 IU (Flagystatin) in the treatment of bacterial vaginosis (BV), candidal and trichomonial vulvovaginitis (CVV, TV), mixed vaginitis and in the prevention of secondary candidal vulvovaginitis.

MATERIALS AND METHODS: Women ages 18-45 years with chief complaints of abnormal vaginal discharge or vaginal/vulvar itching were examined and microbiologic confirmation of BV, VVC, TV or mixed infection was made. They were then randomly assigned to receive either treatment once daily (nightly) for 7 days. A total of 261 subjects had evaluable clinical and microbiological findings at the end of the study. Test of cure by Amsel criteria and Nugent score were performed twice after treatment.

RESULTS: The overall test revealed that microbiological cure rate is significantly different between the two treatment groups.

CONCLUSION: The odds of being cured microbiologically is 2.35 times more in the metronidazole 750mg + miconazole nitrate 200mg group compared to the metronidazole 500 mg + nystatin 10000 IU group. However, no significant difference in the clinical cure between the two groups was found. Both drugs are safe and convenient to use.

Human ; Female ; Adult ; Young Adult ; Vaginosis, Bacterial ; Candidiasis, Vulvovaginal ; Suppositories ; Vaginitis

Objectives. The effect of COVID-19 infection in pregnant women and her neonate is not well-understood, with no clear evidence for vertical transmission. This study aims to determine the maternal and neonatal clinical characteristics and the dyad’s outcomes among those infected with COVID-19 infection. Methods. An ambispective cross-sectional study involving pregnant women with confirmed COVID-19 infection was conducted at the Philippine General Hospital from April to August 2020. Two hundred nine obstetric patients were included, 14 of whom consented to specimen collection to determine vertical transmission. Results. The majority of pregnant women with COVID-19 infection and their neonates had good outcomes. Labor, delivery, and the immediate postpartum course were generally uneventful. The all-cause maternal morbidity rate was high at 75.6 per 100 cases during the five-month study period. COVID-19 related morbidities included the development of Guillain-Barré Syndrome. The in-hospital all-cause maternal mortality rate was 1.91 per 100 cases. The causes of maternal death were acute respiratory failure, septic shock, and congenital heart disease (atrial septal defect with Eisenmengerization). The in-hospital, all-cause neonatal mortality rate was 1.04 per 100 neonates of cases. The lone mother and infant deaths were in a postmortem rt-PCR swab negative mother with an rt-PCR swab positive live neonate who eventually succumbed after nine days of life. All 14 dyads with collected specimens that included amniotic fluid, placental tissue, umbilical cord, and neonate nasopharyngeal swab tested negative for SARS-CoV-2 rt-PCR. Conclusion. The prognosis for COVID-19 infected pregnant patients was generally good, with most of the patients discharged improved. Almost all of the neonates born to COVID-19-infected mothers were stable-term infants. There was no evidence for vertical transmission, as shown by negative rt-PCR results for all the additional specimens obtained. In general, the prognosis for COVID-19 infected dyads was good. The majority of the mothers were discharged well with their term infants. All possible maternal sources of COVID-19 infection to the neonate tested negative. This study provided no evidence for vertical transmission.
regnancy ; Female ; Infant, Newborn ; COVID-19 ; Family

Routine intimate hygiene care has a major contribution in maintaining overall urogenital and perineal health in women. However, Filipino women continue to experience a major surge in vulvar and vaginal symptoms across all age groups, in a context of major changes in lifestyles and risk factors impacting their genital health. Personal beliefs, preferences, apprehensions to discuss intimate topics with health care practitioners (HCPs), availability of cleansing products in the market, and their affordability prevent many women from discussing the role of intimate hygiene care with their HCPs. Communication difficulties and lack of robust evidence, supporting optimal hygiene recommendations are some of the challenges experienced by HCPs. Through this review, the authors discuss the following factors: (i) Differing physiological needs and pathological effects that result from changing dynamics of microflora in the vulvar, perineal, and vaginal region across all age groups of women, (ii) Importance of focusing on perianal and perineal hygiene, and bowel habits, to improve the quality of vulvar hygiene and genital health, (iii) Designing approaches for HCPs to maintain genital health in the light of intimate hygiene, (iv) Recommending improvements in HCP-patient communications to help HCPs dispel the misconceptions pertaining to intimate hygiene practices, and (v) Highlighting the antimicrobial efficacy of feminine hygiene cleansers that preserve the natural microbiome and help maintain the vaginal pH within the normal range. These strategies can fill the knowledge gaps among HCPs, women, and their caregivers’ perspectives and help achieve optimal intimate hygiene.

Human ; Female ; Microbiome ; Microbiota ; Vagina ; Vulva