ArticleBMC pregnancy and childbirth2020
The correlation between the number of vaginal examinations during active labor and febrile morbidity, a retrospective cohort study.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05603624 (Effect of Sterile Versus Clean Gloves Intrapartum and Postpartum Infections at Term), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Sterile Versus Clean Gloves Intrapartum and Postpartum Infections at Term
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Accuracy of non-invasive methods for assessing the progress of labor in the first stage: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2022Pooled it
- Routine vaginal examination to assess labor progress at 8 compared to 4 h after early amniotomy following Foley balloon ripening in the labor induction of nulliparas: A randomized trial.Acta obstetricia et gynecologica Scandinavica · 2024Trial
- Maternal infection in the context of actively managed prelabor rupture of membranes at term: An observational study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Observational
- Prevalence and associated factors of chorioamnionitis among women with preterm premature rupture of membranes at Mbarara Regional Referral Hospital, Southwestern Uganda.BMC pregnancy and childbirth · 2026Article
- Postpartum Pain and Vaginal-Gut Microbiota Interactions: An Integrative Narrative Review with Implications for Maternal Recovery and Pain Modulation.Journal of pain research · 2026Review
- Gut microbiome differences after vaginal birth in relation to rupture of membranes at term: a prospective longitudinal cohort study of twins.European journal of pediatrics · 2025Article
- Membrane Status and Reliability of Intrapartum Transperineal Ultrasound in Cervical Dilatation Assessment.Healthcare (Basel, Switzerland) · 2025Article
- Increasing number of cervical examinations in term labor does not increase the risk of maternal intrapartum fever.Pregnancy (Hoboken, N.J.) · 2025Article
- Development and validation of a machine learning model for predicting intrapartum fever using pre-labor analgesia clinical indicators: a multicenter retrospective study.BMC pregnancy and childbirth · 2025Article
- Maternal postpartum infection risk following induction of labor: A Danish national cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Psychosocial needs of women undergoing perinatal intimate examinations.Health SA = SA Gesondheid · 2025Article
- Prevalence of Maternal Fever and Associated Factors among Postnatal Women at Kawempe National Referral Hospital, Uganda: A Preliminary Study.International journal of environmental research and public health · 2024Article
- Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment.American journal of obstetrics and gynecology · 2024Review
- The epidemiology and risk factors for postnatal complications among postpartum women and newborns in southwestern Uganda: A prospective cohort study.PLOS global public health · 2024Article
- Intrapartum transperineal ultrasound: angle of progression to evaluate and predict the mode of delivery and labor progression.Obstetrics & gynecology science · 2024Article
- Risk of adverse perinatal outcomes among women with clinical and subclinical histopathological chorioamnionitis.Frontiers in medicine · 2024Article
- Impacts of embracing 39-week elective induction across an entire labor and delivery unit.AJOG global reports · 2023Article
- Learning Obstetrical Cervical Exam Skills : Development of a Novel Model to Demystify Blind Procedures.Family medicine · 2023Article
- Development and Application of "Cervical Dilatation Model for Teaching and Training".Advances in medical education and practice · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between the number of vaginal examinations (VEs) performed during labor and the risk of infection is unclear. The literature regarding this issue is not consensual, and the available studies are relatively small. Therefore, we aimed to study the association between the number of VEs during labor, and maternal febrile morbidity, in a very large cohort.
methodsThis is a retrospective cohort study. All women who delivered vaginally ≥37 weeks, at our institute, between 2008 and 2017 were included. Patients who underwent cesarean delivery or who were treated with prophylactic antibiotics, or had a fever ≥38.0 °C prior to the first VE were excluded. Cases of intrauterine fetal death, known malformations, or missing data were excluded as well. The cohort was divided according to the number of VEs performed: up to 4 VEs (n = 9716), 5-6 VEs (n = 4624), 7-8 VEs (n = 2999), and 9 or more VEs (n = 4844). The rates of intrapartum febrile morbidity (intrapartum fever and chorioamnionitis), postpartum febrile morbidity (postpartum fever and endometritis), and peripartum febrile morbidity (any of the mentioned complications) were compared.
resultsOverall, 22,183 women were included in the study. On multivariate analysis, we found that performing 5 VEs or more during labor was independently associated with intrapartum febrile morbidity (5-6 VEs: aOR = 1.83, 95% CI (1.29-2.61), 7-8 VEs: aOR = 2.65 95% CI (1.87-3.76), 9 or more VEs aOR = 3.47 95% CI (2.44-4.92)), postpartum febrile morbidity (5-6 VEs: aOR = 1.29, 95% CI (1.09-1.86), 7-8 VEs: aOR = 1.94 95% CI (1.33-2.83), 9 or more VEs aOR = 1.91 95% CI (1.28-2.82)), and peripartum morbidity (5-6 VEs: aOR = 1.48, 95% CI (1.15-1.91), 7-8 VEs: aOR = 2.15 95% CI (1.66-2.78), 9 or more VEs: aOR = 2.57 95% CI (1.97-3.34)).
conclusionThe number of VEs performed during labor is directly correlated with febrile morbidity. Performing five or more VEs during labor is independently associated with febrile morbidity; For intrapartum and peripartum febrile morbidity the risk rises as more VEs are performed.
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