الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cesarean section is a surgical opreation as incisions are made through women abdomen and uterus to deliver baby .
Endometritis is an inflammation of endometrial linning of uterus.in addition to endometruim, inflammation may involve the myometruim and occasionally the parametruim
Diagnosis usually based on clinical findings, as follows: Fever, lower abdominal pain, foul-smelling lochia, abnormal vaginal bleeding, abnormal vaginal discharge.
The most recognized risk factors for developing post- cesarean endometritis involve pathways that introduce large quantities of bacteria into uterine cavity. These include excessive vaginal examination in labor, prolonged duration of active labor prolonged membrane rupture.
The bacterial species implicated in post-cesarean endometritis and wound infection include gram positivecocci and anaerobic bacilli associated with bacterial vaginosis.
The infection rate for endometritis varied by mode of delivery: vaginal, 3.6%; elective repeat caesarean delivery, 6.0; nonurgent primary caesarean delivery, 22.2%; and emergency caesarean, 38.4%.
To reduce the incidence of endometritis, antibiotic prophylaxis at the time of caesarean delivery has become a common practice.
A study of rectal metrodiazole suppositiories resulted in clinical curein 87% of women with bacterial vaginosis. This observation suggest that rectal administration of metronidazole before delivery might reduce the prevalence of vaginal anaerobes,thereby reduce the incidence of postpartum endometritis.
The present study aimed to assess the efficacy of rectally administered metronidazole to prevent post partum endometritis after emergency caesarean section.
Our study carried on 200 women made emergency caesarean section .
The study population divided into two groups the first group(a) which received metronidazole rectal suppositiories in addition to the prophylactic antibiotic protocol at Edfu general hospital in Aswan while the other group(b) received the prophylactic antibiotic protocol at Edfu general hospital in Aswan .the results showed no significant difference between the both groups as regarding age (years), gestational age (weeks), parity, previous cesarean section, excessive vaginal examination, prolonged rupture of membranes (more than 18 hours) pre and postoperative haemoglobin (gm/dL). But it showed significant results in preventing postpartum enodmetritis in group(a) which received metronidazole rectal suppositories as there was less leukocytosis,negative CRP titre,less postoperative hospital stay,no fever more than 38c on any of 2 days post operative excluding the first 24 hours after delivery,less uterine tenderness and less offensive vaginal discharge.