Amniotic fluid cultures: post-cesarean section endomyometritis and neonatal infections

Amniotic fluid cultures in 54 consecutive patients undergoing cesarean section were compared in regard to intrapartum and postpartum events. Neonatal outcome and cultures were also compared with amniotic fluid findings. Positive amniotic cultures were obtained in 57% and showed a multiplicity of organisms. Development of endomyometritis was correlated with a heavy growth of bacteria in culture. Positive cultures were significantly associated with duration of labor greater than eight hours and presence of ruptured membranes at the time of cesarean section. Thirty-three percent of the patients with positive cultures had intact membranes at the time of operation. Eighty-eight percent of cultures from infants and amniotic fluid grew organisms in common. Implications of the study for the pathogenesis of postcesarean endomyometritis and neonatal morbidity are discussed.