Poster Session 1
Daniel J. Martingano, DO, MBA, PhD
Clerkship Director, IRB Chair, Associate Program Director / Division Chair
St. John's Episcopal Hospital-South Shore and William Carey University College of Osteopathic Medicine
Far Rockaway, New York, United States
Amanda F. Francis Oladipo, MD, MSCR (she/her/hers)
Director of Research
Hackensack University Medical Center
Hackensack, New Jersey, United States
Marwah Al-Dulaimi, MD (she/her/hers)
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, NY, United States
Sandra Kumwong, MS
Medical Student
Touro College of Osteopathic Medicine-Harlem Campus
New York, New York, United States
Andrea Ouyang, MSc
Medical Student
William Carey University
Hattiesburg, Mississippi, United States
Lauren Cue, MD, BA (she/her/hers)
OB/GYN Resident
Rutgers University and the Jersey City Medical Center
Jersey City, New Jersey, United States
Ashley Nguyen, MD
OB/GYN Resident
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Francis X. Martingano, MD
Assistant Professor, Senior Minimally Invasive Surgeon
NYU Grossman School of Medicine - NYU Brooklyn
New York, New York, United States
Shailini Singh, MD
Director of Metabolic Syndrome
AtlantiCare Regional Medical Center
Pamona, New Jersey, United States
Mark Rebolos, MD
Director of Patient Safety, Labor & Delivery
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Alexander Ulfers, DO
Medical Director, Maternal Infant Care Center; Maj, USAF, MC
Walter Reed National Military Medical Center
Bethesda, Maryland, United States
Kristin Cohen, CNM, DNP
Women's Health Care Practitioner
RWJBarnabas Health - Trinitas Regional Medical Center
Elizabeth, New Jersey, United States
Donald Morrish, MD
Chief Executive Officer
St. John's Episcopal Hospital-South Shore
Far Rockaway, New York, United States
Iffath A. Hoskins, MD
Former ACOG President, Director of Labor & Delivery, Chief Safety Officer
Albert Einstein College of Medicine - Montefiore Medical Center
New York, New York, United States
Balloon and vacuum-induced tamponade devices provide alternative treatment options in cases of postpartum hemorrhage when first-line uterotonic agents either fail or are contraindicated. This study sought to determine if antibiotic prophylaxis at time of intrauterine balloon tamponade (IBT) or vacuum-induced tamponade (VID) insertion in vaginal deliveries complicated by postpartum hemorrhage effects subsequent rates of postpartum endometritis.
Study Design:
We conducted a prospective observation cohort study comparing all patients who received an IBT following vaginal delivery to those who did not from dates 7/2022 through 7/2024. Patients were excluded if additional antibiotics apart from penicillin for GBS prophylaxis were administered, were gestational age < 34 weeks, or had an allergy to antibiotic therapy. Patients receiving antibiotics specifically were given cefazolin 1g every 8 hours until removal of IBT or VID.
Results:
The study included 415 patients, where 313 patients received IBT and 102 received VID. In the IBT group, 160 received antibiotics and 153 did not. In the VID group 55 received antibiotics and 47 did not. Demographic factors were not significantly different. Rates of postpartum endometritis were less in the IBT antibiotic group (5.6% versus 13.7%, p = 0.003) in addition to a 37% decreased risk in confounder adjusted models (RR=0.63, 95% CI 0.47-0.75, p = 0.041). Rates of postpartum endometritis were not significantly different in the unstratified VID group. In stratified analysis, rates of postpartum endometritis were less in the VID antibiotic groups for nulliparous patients (0.55% v. 2.35%, p=0.001), with a 11% decreased risk in adjusted models (RR=0.89, 95% CI 0.72-0.97, p=0.034).
Conclusion:
Antibiotic prophylaxis at time of IBT for vaginal deliveries complicated by postpartum hemorrhage is reasonable for endometritis prevention with potential benefits for VID use in nulliparous patients.
