Transactions of the 71st Annual Meeting of the Central Association of Obstetricians and GynecologistsTiming of prophylactic antibiotic administration in the uninfected laboring gravida: A randomized clinical trial
Section snippets
Material and methods
In this prospective randomized study, women were eligible if they were in active labor and subsequently required a cesarean section. Patients were excluded if they had acute chorioamnionitis, allergy to penicillin or cephalosporins, cesarean section without labor, or the administration of systemic antibiotics within the past 2 weeks. Group B Strep prophylaxis (aqueous penicillin 5 million units IV then 3 million units q 4 hours), was allowed, and all patients, if indicated, received the same
Results
Over a 30-month period 342 patients with singleton pregnancies entered the trial. Twenty-three women in the skin incision group (A) and 21 in the cord clamp group (B) were found to have exclusion factors (Figure), leaving 153-group A, 149-group B. Patients were excluded if on final analysis, they were not in true, active labor (A = 12, B = 12), delivered vaginally before abdominal birth was performed (A = 4, B = 1). Chorioamnionitis was diagnosed (A = 4, B = 4), or antibiotics usage was confirmed during
Comment
Traditionally, prophylactic antibiotics are given preoperatively in obstetric/gynecologic procedures, and this is in keeping with general surgical principles. In 1961, Burke et al first demonstrated in an animal model that infection rates were decreased in contaminated skin wounds when antibiotics were given before contamination of the wound.11 This intuitive finding is widely accepted among the medical community and has been confirmed in many human studies. However, in the case of cesarean
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Presented at the 71st Annual Meeting of the Central Association of Obstetricians and Gynecologists, October 13-16, 2004, Washington, DC.
Reprints not available from the authors.