Interventions
All the patients were informed of the potential benefits and risks of
ECC, signed informed consent. The attending physicians were senior
obstetricians and their fixed team. The preoperative evaluation included
assessment of vaginal bleeding or discharge, serum white blood cell
(WBC) count and C-reactive protein level, intra-amniotic infection, and
uterine contractions. The degree of cervical dilation was determined by
pelvic exam and/or speculum exam and specimens for
mycoplasma,
chlamydia, bacterial vaginosis, candidiasis and trichomonas’s were
collected at the time of exam. An isolated finding of vaginal discharge
was evaluated for a definitive diagnosis and antibiotics were used for
at least 48 hours empirically according to a drug sensitivity test.
Patients tested positive for chlamydia and their sexual partners were
treated. Clinical chorioamnionitis was defined as maternal fever of ≥38°
C with one of the following conditions: maternal tachycardia
(>100 beats/minute), fetal tachycardia, (>160
beats/minute), WBC >15 × 103/L, or
uterine tenderness. Evidence of intra-amniotic infection was a
contraindication for ECC. Preoperative prophylactic antibiotics was
offered to all patients, and perioperative indomethacin and nifedipine
were administered and continued 48 hours postoperatively.