<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-5830</journal-id>
<journal-title><![CDATA[Acta Obstétrica e Ginecológica Portuguesa]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Obstet Ginecol Port]]></abbrev-journal-title>
<issn>1646-5830</issn>
<publisher>
<publisher-name><![CDATA[Euromédice, Edições Médicas Lda.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-58302024000400290</article-id>
<article-id pub-id-type="doi">10.69729/aogp.v18i4a04</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Is there a relation between operative birth and postpartum infection? - an observational longitudinal study]]></article-title>
<article-title xml:lang="pt"><![CDATA[Existe uma relação entre o parto instrumentado e a infeção pós-parto? - um estudo observacional longitudinal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores-Casteleiro]]></surname>
<given-names><![CDATA[Maria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sarabando]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Forjaz]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almendra]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barbosa]]></surname>
<given-names><![CDATA[Paulina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coelho]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nogueira-Silva]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Braga Department of Obstetrics and Gynecology ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Minho School of Medicine ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de Braga Department of Obstetrics and Gynecology ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Minho Life and Health Sciences Research Institute (ICVS) School of Medicine]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>18</volume>
<numero>4</numero>
<fpage>290</fpage>
<lpage>298</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-58302024000400290&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-58302024000400290&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-58302024000400290&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Overview and Aims:  In high-income countries, 5% of puerperal deaths are due to postpartum infections. Although there is clear evidence that antibiotic prophylaxis before caesarean section reduces the incidence of infection, there is less evidence in operative birth. The aim of this study was to compare the prevalence of puerperal infection between operative birth and spontaneous vaginal birth, finding independent risk factors for it.  Study design:  A prospective observational study was carried out at the Obstetrics Department of a public hospital.  Population:  Patients with a vaginal birth were enrolled in this study, and for each operative birth a spontaneous vaginal birth was recruited in a ratio of 1:1.  Methods:  Data was collected in the first 24 hours after the birth and 6 weeks after birth, when a telephone survey was performed to assess the occurrence of infection.  Results:  385 postpartum women were included, 35 (9.1%) developed postpartum infection. The prevalence of infection in the operative birth group was higher (13.4% vs. 4.7%; p=0.003). In the same group most women were nulliparous (74.7% vs. 45.5%, p&lt;0.001), the median duration of membrane rupture and active phase of labor was higher (5.5 hours, vs. 3.0 hours, p&lt;0.001; 4.8 hours, vs. 3.0 hours, p&lt;0.001), more episiotomies were performed (92.8% vs. 37.7%; p&lt;0.001) and fewer grade I or II perineal lacerations occurred (6.2% vs. 25.1%; p&lt;0.001). In the logistic regression, anemia was the only independent predictor of infection (p&lt;0.001; correctly predicted cases=90.8%).  Conclusion:  Although the prevalence of postpartum infection was higher after operative birth, it was not an independent risk factor. This reiterates the need to continue the investigation of operative birth contribution to postpartum infection. Before considering generalizing antibiotic prophylaxis, maybe each institution needs to analyze local data and think about how to control other possible risk factors for infection.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução e Objetivo:  Nos países desenvolvidos, 5% das mortes puerperais devem-se a infeções pós-parto. Embora haja evidência clara de que a profilaxia antibiótica da cesariana reduz a incidência de infeção, esta evidência é menor no parto instrumentado. O objetivo deste estudo foi comparar a prevalência de infeção puerperal entre o parto instrumentado e o parto eutócico, investigando fatores de risco independentes para a mesma.  Desenho do estudo:  Estudo prospetivo observacional realizado no Serviço de Obstetrícia de um hospital público.  População:  Foram incluídas as puérperas com parto vaginal. A cada parto instrumentado, juntou-se um parto eutócico numa proporção de 1:1.  Métodos:  Os dados foram recolhidos 24 horas e 6 semanas após o parto, altura em que foi realizado um inquérito telefónico para avaliar a ocorrência de infeção.  Resultados:  Foram incluídas 385 puérperas, 35 (9,1%) desenvolveram infeção no pós-parto. A prevalência de infeção no grupo de parto instrumentado foi maior (13,4% vs. 4,7%; p=0,003). No mesmo grupo a maioria das mulheres eram nulíparas (74,7% vs. 45,5%, p&lt;0,001), a duração mediana da rotura de membranas e da fase ativa do trabalho de parto foi superior (5,5 horas, vs. 3,0 horas, p&lt;0. 001; 4,8 horas, vs. 3,0 horas, p&lt;0,001), foram realizadas mais episiotomias (92,8% vs. 37,7%; p&lt;0,001) e ocorreram menos lacerações perineais grau I ou II (6,2% vs. 25,1%; p&lt;0,001). Na regressão logística, a anemia foi o único preditor independente de infeção (p&lt;0,001; casos corretamente previstos=90,8%).  Conclusões:  Embora a prevalência de infeção pós-parto tenha sido superior no parto instrumentado, este não foi um fator de risco independente. Facto que reitera a necessidade de continuar a investigar a contribuição do parto instrumentado para a infeção pós-parto. Antes de generalizar a profilaxia antibiótica, talvez seja necessário que cada instituição analise os dados locais e pondere formas de controlar outros fatores de risco de infeção.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Postpartum infection]]></kwd>
<kwd lng="en"><![CDATA[Operative birth]]></kwd>
<kwd lng="en"><![CDATA[Postpartum anemia.]]></kwd>
<kwd lng="pt"><![CDATA[Infeção pós-parto, Parto instrumentado]]></kwd>
<kwd lng="pt"><![CDATA[Anemia pós-parto.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Say]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chou]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Gemmill]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tunçalp]]></surname>
<given-names><![CDATA[Ö]]></given-names>
</name>
<name>
<surname><![CDATA[Moller]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Daniels]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global causes of maternal death a WHO systematic analysis]]></article-title>
<source><![CDATA[Lancet Glob Health]]></source>
<year>2014</year>
<volume>2</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>e323-33</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Creanga]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Syverson]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Seed]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Callaghan]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pregnancy-related mortality in the United States, 2011-2013]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>2017</year>
<volume>130</volume>
<page-range>366-73</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smail]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
<name>
<surname><![CDATA[Grivell]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotic prophylaxis versus no prophylaxis for preventing infection after caesarean section]]></article-title>
<source><![CDATA[Cochrane Database Syst Rev]]></source>
<year>2014</year>
<volume>10</volume>
<page-range>CD007482</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bonet]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Souza]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Abalos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Fawole]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kouanda]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The global maternity sepsis study and awareness campaign (GLOSS): study protocol]]></article-title>
<source><![CDATA[Reprod. Health]]></source>
<year>2018</year>
<volume>15</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>16</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mohamed-Ahmed]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Hinshaw]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Operative vaginal delivery and postpartum infection]]></article-title>
<source><![CDATA[Best Pract Res Clin Obstet Gynaecol]]></source>
<year>2018</year>
<volume>56</volume>
<page-range>93-106</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murphy]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Strachan]]></surname>
<given-names><![CDATA[BK]]></given-names>
</name>
<name>
<surname><![CDATA[Bahl]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assisted Vaginal Birth]]></article-title>
<collab>on behalf of the Royal College of Obstetricians Gynaecologists</collab>
<source><![CDATA[BJOG]]></source>
<year>2020</year>
<volume>127</volume>
<page-range>e70-112</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<collab>The Royal Australian and New Zealand College of Obstetricians and Gynaecologists</collab>
<source><![CDATA[Instrumental Vaginal Birth]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<collab>WHO</collab>
<source><![CDATA[recommendation on routine antibiotic prophylaxis for women undergoing operative vaginal birth]]></source>
<year>2021</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[World Health Organization]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<collab>American College of Obstetricians and Gynecologists' Committee on Practice Bulletins - Obstetrics</collab>
<article-title xml:lang=""><![CDATA[Operative Vaginal Birth ACOG Practice Bulletin, Number 219; Obstet]]></article-title>
<source><![CDATA[Gynecol]]></source>
<year>2020</year>
<volume>135</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e149-59</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van Schalkwyk]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Van Eyk]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[No 247 - Antibiotic Prophylaxis in Obstetric Procedures]]></article-title>
<source><![CDATA[J Obstet Gynaecol Can]]></source>
<year>2017</year>
<volume>39</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>e293-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liabsuetrakul]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Choobun]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Peeyananjarassri]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Islam]]></surname>
<given-names><![CDATA[QM.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antibiotic prophylaxis for operative vaginal delivery]]></article-title>
<source><![CDATA[Cochrane Database Syst Rev]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chiocchia]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Partlett]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Rivero-Arias]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Hua]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Hinshaw]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ANODE collaborative group. Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2019</year>
<volume>393</volume>
<numero>10189</numero>
<issue>10189</issue>
<page-range>2395-403</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berhan]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kirba]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gebre]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Still No Substantial Evidence to Use Prophylactic Antibiotic at Operative Vaginal Delivery Systematic Review and Meta-Analysis]]></article-title>
<source><![CDATA[Obstet Gynecol Int]]></source>
<year>2020</year>
<page-range>1582653</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Kurinczuk]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lucas]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Tuffnell]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Sellers]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe maternal sepsis in the]]></article-title>
<collab>&amp;ampUnited Kingdom Obstetric Surveillance System</collab>
<source><![CDATA[UK, 2011-]]></source>
<year>2012</year>
<page-range>a</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Bhattacharya]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tuffnell]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kurinczuk]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Maternal sepsis a Scottish population-based case-control study]]></article-title>
<source><![CDATA[BJOG]]></source>
<year>2012</year>
<volume>119</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>474-83</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Heaman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Joseph]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Liston]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sauve]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk of maternal postpartum readmission associated with mode of delivery]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>2005</year>
<page-range>105</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Axelsson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Brynhildsen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Blomberg]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Postpartum infection in relation to maternal characteristics, obstetric interventions and complications]]></article-title>
<source><![CDATA[J Perinat Med]]></source>
<year>2018</year>
<volume>46</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>271-8</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lydon-Rochelle]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Holt]]></surname>
<given-names><![CDATA[VL]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Easterling]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between method of delivery and maternal rehospitalization]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2000</year>
<volume>283</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>2411-6</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Knight]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
<name>
<surname><![CDATA[Kurinczuk]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gould]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Lyndon]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The continuum of maternal sepsis severity incidence and risk factors in a population-based cohort study]]></article-title>
<source><![CDATA[PloS one]]></source>
<year>2013</year>
<volume>8</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stephansson]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Sandström]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Petersson]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wikström]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Cnattingius]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prolonged second stage of labour, maternal infectious disease, urinary retention and other complications in the early postpartum period]]></article-title>
<source><![CDATA[BJOG]]></source>
<year>2016</year>
<volume>123</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>608-16</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Du]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors, changes in serum inflammatory factors, and clinical prevention and control measures for puerperal infection]]></article-title>
<source><![CDATA[J Clin Lab Anal]]></source>
<year>2020</year>
<volume>34</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gommesen]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Nohr]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Drue]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
<name>
<surname><![CDATA[Qvist]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Rasch]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetric perineal tears risk factors, wound infection and dehiscence: a prospective cohort study]]></article-title>
<source><![CDATA[Arch Gynecol Obstet]]></source>
<year>2019</year>
<volume>300</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>67-77</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Soliman]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Ghareeb]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Elhameid]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Lashin]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interrupted Versus Continuous Suturing of Episiotomy A Comparative Study]]></article-title>
<source><![CDATA[Zagazig University Medical Journal]]></source>
<year>2020</year>
<volume>26</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>287-96</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Macleod]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Strachan]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Bahl]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Howarth]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Goyder]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A prospective cohort study of maternal and neonatal morbidity in relation to use of episiotomy at operative vaginal delivery]]></article-title>
<collab>Van de Venne M</collab>
<source><![CDATA[BJOG]]></source>
<year>2008</year>
<volume>115</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>1688-94</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bailit]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Grobman]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
<name>
<surname><![CDATA[Rice]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Wapner]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Reddy]]></surname>
<given-names><![CDATA[UM]]></given-names>
</name>
<name>
<surname><![CDATA[Varner]]></surname>
<given-names><![CDATA[MW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of delivery options for second-stage events]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2016</year>
<volume>214</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>638</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
