Could subcutaneous rifampicin administration be an effective approach for reducing episiotomy infections?

OBJECTIVE: The aim of this prospective cross-sectional study was to investigate whether cleaning the episiotomy line with rifampicin solution before suturing will reduce infection and wound dehiscence in women who had vaginal delivery with episiotomy. PATIENTS AND METHODS: A prospective cross-sectional study was conducted with a total of 400 primigravida patients. In the study group, irrigation with rifampicin of the subcutaneous tissue of the episiotomy incision was applied, and in the control group, there was no irrigation. Patients were evaluated for infection at the 1st, 3rd week, and 1-month controls. The groups were compared according to episiotomy infection and wound dehiscence rates. RESULTS: The episiotomy infection rate of the whole group was 8.5%, the wound dehiscence rate was 3.75%, and the average time of occurrence of the infection was 5.35±2.21 days. The most common infection findings were local pain and purulent discharge at 4.75%. In the control group, where the infection occurred earlier, the infection and wound dehiscence rates were significantly higher [11.5% vs. 5.5%; 6.0% vs. 1.5% (p<0.05)]. Purulent discharge was the most common finding in the control group, and local pain in the study group, but no significant difference was found between the two groups in terms of findings (p<0.05). When only the patients who developed episiotomy infection were evaluated among themselves, the only significant difference was found in wound dehiscence, which was higher in the control group (p<0.05). CONCLUSIONS: Considering the high rates of episiotomy in our country, subcutaneous irrigation with rifampicin is a good option that can be kept in the foreground due to its low cost and ease of application.

Intrauterine insemination in ovulatory infertile patients.

AIM: Although there are many studies in literature comparing intrauterine insemination (IUI) and timed intercourse, there are only a few studies examining the use of clomiphene citrate (CC) in ovulatory infertile patients. The aim of this study was to compare IUI following CC-induced ovulation and timed intercourse following CC-induced ovulation in ovulatory infertile patients. METHODS: Hundred patients who had IUI or timed intercourse following ovulation induction (OI) via CC between 2012 and 2014 are prospectively scanned. Both groups were consisted of 50 patients. Both in groups 1 and 2 patients, the treatment with clomiphene citrate was started on the 3rd day of the menstrual cycle with a dose of 50 mg/day and was continued for 5 consecutive days. On the 13th day of the cycle, the patients were called for examination and folliculometry tests were performed via transvaginal ultrasonography. Human chorionic gonadotropin (HCG, a prepared syringe containing 250 µg/0.5 ml [6,500 IU equivalent] choriogonadotropin alpha) was given to all patients with a sufficient size follicle (18-20 mm). Group 1 patients were recommended to have coitus regularly for a week after the HCG treatment. In group 2, IUI was performed 36 h after the HCG treatment. RESULTS: Clinical pregnancy was provided in 28 patients in 100 patients. In group 1, the pregnancy rate per person was 6%, the pregnancy rate per cycle was 2.3%, and live birth rate was 6%. In group 2, the pregnancy rate per person was 22%, the pregnancy rate per cycle was 8.3%, and live birth rate was 23%. A statistically significant difference was observed between groups 1 and 2 in terms of pregnancy per person rate, pregnancy per cycle rate, and live birth rate. CONCLUSION: In the patients who had OI via CC, the pregnancy rates obtained with IUI were statistically significantly higher than timed intercourse.