Home > Search Results

Results: 1 to 20 of 29

Antibiotic regimens for postpartum endometritis

Intravenous clindamycin plus gentamicin is more effective than other antibiotics or combinations of antibiotics for treatment of womb infection after childbirth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Vaginal cleansing before cesarean delivery to reduce post‐cesarean infections

Cesarean deliveries are very common today, with almost one in three babies born by cesarean in some countries. Antibiotics are routinely given before or during the surgery to reduce the risk of infections, but some women still suffer from these complications. Between one in four and one in 10 women develop an infection of the uterus (endometritis) or a problem with their skin incision, respectively. These complications slow recovery from the surgery and may affect the mother's ability to take care of her baby. Other interventions are needed to further reduce the risk of infections of the uterus and wound problems after cesarean delivery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Placenta delivery at caesarean section

There are various methods of delivery of placenta at caesarean section. These include placental drainage with spontaneous delivery, cord traction and manual removal. The last two methods: cord traction (usually combined with massage or expression of the uterus) and manual removal are frequently used. The review identified 15 studies involving 4694 women. Delivery of the placenta by cord traction at caesarean section has more advantages compared to manual removal. These are less endometritis; less blood loss; less decrease in haematocrit levels postoperatively; and shorter duration of hospital stay.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Amnioinfusion for potential or suspected umbilical cord compression in labour

Infusing fluid into the uterus during labour may reduce fetal heart rate abnormalities and reduce caesarean sections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Routine antibiotics at cesarean section to reduce infection

Women undergoing cesarean section have a five to 20‐fold greater chance of getting an infection compared with women who give birth vaginally. These infections can be in the organs within the pelvis, around the surgical incision and sometimes the urine. The infections can be serious, and very occasionally can lead to the mother’s death. The potential benefits of reducing infection for the mother need to be balanced against any adverse effects such as nausea, vomiting, skin rash and rarely allergic reactions in the mother, and any effect of antibiotics on the baby, including thrush. This review looked at whether antibiotics are effective in preventing infection in women having a cesarean section. It also studied the effect of giving the antibiotics before or after the cord is clamped and different kinds of antibiotics. The review found 95 studies involving over 15,000 women. Routine use of antibiotics at cesarean section reduced the risk of wound and womb infections in mothers as well as the risk of serious complications of infections for the mothers by 60% to 70%. This was so whether the cesarean section was planned (elective) or not, and whether the antibiotics were given before or after clamping of the umbilical cord. The evidence to support antibiotic treatment was of moderate quality but often the way the study was done was not described well enough. None of the studies looked properly at possible adverse effects on the baby and so, although there are benefits for the mother, there is some uncertainty about whether there are any important effects on the baby.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Skin preparation for preventing infection following caesarean section

Surgical site infections are the third most frequently reported hospital‐ acquired infection. Women who give birth by caesarean section are exposed to the possibility of infection from their own, and external or environmental, sources of infection. Preventing infection by properly preparing the skin before incision is thus a vital part of the overall care given to women prior to caesarean birth. An antiseptic is applied to remove or reduce bacteria. These antiseptics include iodine or povidone‐iodine, alcohol, chlorhexidine and parachlorometaxylenol and can be applied as liquids or powders, scrubs, paints, swabs or on impregnated drapes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotics for meconium‐stained amniotic fluid in labour for preventing maternal and neonatal infections

Meconium‐stained amniotic fluid (MSAF) is the result of waste material from the fetal colon passing into the mother's amniotic cavity. Its incidence increases in post‐term pregnancies. Pregnant women with MSAF are more likely to develop maternal complications including inflammation of the fetal membranes caused by a bacterial infection (chorioamnionitis), postpartum inflammation of the lining of the uterus (endometritis) and neonatal complications such as neonatal sepsis and the need for admission to a neonatal intensive care unit (NICU). Fetal stress or hypoxia may trigger gasping fetal respirations, which results in the aspiration of meconium.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding group B streptococcal and HIV)

Bacteria live in women's vaginas and generally cause no problems. Very occasionally they infect the placenta during labour and can pass to the baby, causing an infection. These infections can occasionally make the baby very ill and very occasionally the baby might die.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotic prophylaxis for operative vaginal delivery

Vacuum and forceps assisted vaginal births are reported to increase the incidence of postpartum infections and maternal readmission to hospital compared to spontaneous vaginal birth. The commonest indications for operative vaginal delivery are prolonged second stage of labour, suspicion of immediate or potential fetal compromise and shortening of the second stage of labour for maternal benefit.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Mechanical dilatation of the cervix at non‐labour caesarean section for reducing postoperative morbidity

A woman's cervix is firm and undilated at the beginning of pregnancy, but progressively softens all the way to term. The progressive dilatation of the cervix occurs with uterine contractions during labour. Mechanical dilatation of the cervix at caesarean section before onset of labour is the artificial dilatation of the cervix performed by the surgeon using a finger, sponge forceps or other surgical instruments. Some obstetricians believe that dilating the cervix helps the drainage of blood following the birth (postpartum), thus reducing intrauterine infection or the risk of postpartum haemorrhage. Indeed, the mechanical cervical dilatation could result in contamination of the uterus by vaginal micro‐organisms and increase the risk of infections or cervical trauma. This review found three randomised controlled trials involving 735 women undergoing elective non‐labour caesarean section at more than 37 weeks' gestation. The number of women with a fever and the blood haemoglobin levels in the postoperative period were not clearly different between women who underwent cervical dilatation during caesarean section and those who did not. The incidence of infections such as wound infection, endometritis or urinary tract infection was also not clearly different. Many outcomes were reported in only one study with low numbers of women and a low power of the statistics. This meant there was insufficient evidence of mechanical dilatation of the cervix at non‐labour caesarean section for reducing postoperative morbidity.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibiotic prophylaxis during the second and third trimester in pregnancy to reduce adverse pregnancy outcomes and morbidity

Antibiotics are administered to pregnant women during the second and third trimester of pregnancy (before labour) to prevent bacteria in the vagina and cervix affecting the pregnancy. Infection by some infectious organisms in a woman’s genital tract can cause health problems for the mother and her baby, and has been associated with preterm births. This review of eight randomised trials involved approximately 4300 women in their second or third trimester. We found that antibiotics did not reduce the risk of preterm prelabour rupture of the membranes (one trial, low quality of evidence), or the risk of preterm birth (six trials, highquality of evidence). Preterm delivery was reduced in pregnant women who had a previous preterm birth and an imbalance of bacteria in the vagina (bacterial vaginosis) during the current pregnancy. There was no reduction in preterm delivery in pregnant women with previous preterm birth without a bacterial imbalance during the current pregnancy (two trials). Postpartum endometritis, or infection of the uterus following birth, was reduced overall (three trials, moderate quality of evidence), as well as in a trial of high‐risk women who had a previous preterm birth (one trial, moderate quality of evidence). No reduction in neonatal illness was observed. Outcomes of interest were available in trials with high losses to follow‐up. We could not estimate the side effects of antibiotics since side effects were rare; however, antibiotics may still have serious side effects on women and their babies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

What is the most effective and safe way to administer antibiotics to prevent infection for women undergoing caesarean section

Caesarean delivery increases the risk for infection compared to vaginal birth by five‐ to 20‐fold. Infections can be of the surgical incision, the lining of the uterus, and inside the pelvis. Clinicians seek to prevent these infections by different measures including prophylactic (preventative) antibiotics.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth

We did not identify any trials to say if women with retained placenta after giving birth would benefit from routine antibiotics prior to manual removal of placenta.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour

Amnioinfusion can help when a baby is surrounded by too little fluid in the womb (oligohydramnios) and is showing distress, but is not needed otherwise.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Comparing different types of antibiotics given routinely to women at caesarean section to prevent infections

Women undergoing caesarean section have an increased likelihood of infection compared with women who give birth vaginally. These infections can be in the urine, surgical incision, or the lining of the womb (endometritis). The infections can become serious, causing, for example, an abscess in the pelvis or infection in the blood, and very occasionally can lead to the mother's death. Sound surgical techniques are important for reducing infections, along with skin antiseptics and antibiotics. However, antibiotics can cause adverse effects such as nausea, vomiting, skin rash and rarely allergic reactions in the mother, and the risk of thrush (candida) for the mother and the baby. Antibiotics, given to women around the time of giving birth, can also change the baby's gut flora and thus may interfere with the baby's developing immune system.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotics for rupture of membranes when a pregnant women is at or near term but not in labour

Sometimes the protective bag of fluid around an unborn baby (the membranes) break when the baby is due without the onset of labour (regular uterine contractions). This is called PROM or prelabour rupture of the membranes. When this happens there is a risk of infection entering the womb (uterus) and affecting the mother and her baby. Newborn infections are rare but have the potential to cause serious harm requiring neonatal intensive care. Giving a pregnant woman antibiotics when she has PROM may reduce the risk of infections for the woman and her baby. Most women spontaneously start labour within 24 hours, so delaying induction of labour and waiting for spontaneous onset of labour (expectant management) may be a possibility. Another treatment for term PROM is to induce labour with oxytocin or prostaglandins. Women are often given antibiotics to prevent infection, but there are concerns about possible side‐effects of antibiotics, and that overuse of antibiotics can cause resistance to antibiotics so that they become less effective.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotics for gonorrhoea in pregnancy

Pregnant women with gonorrhoea who take penicillin, spectinomycin or ceftriaxone are much less likely to show signs of infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

When should antibiotics be given to prevent infectious complications after cesarean birth?

People who undergo surgery are at risk of developing infections, which complicate their recovery. In order to prevent these infections and reduce complications, antibiotics are sometimes given as a preventative (or prophylactic) treatment. The antibiotics are generally given approximately 60 minutes before the operation so that adequate tissue concentrations are reached before the skin is cut. For cesarean deliveries however, the effect of the antibiotic on the baby has to be considered, and for this reason antibiotics have been administered to women after the baby’s umbilical cord is clamped. This may not allow for adequate tissue penetration in the mother for the prevention of surgery‐related infections; additionally deferring antibiotics may not benefit the newborn.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more)

Some evidence in favour of planned management (usually by induction) when women have prelabour rupture of membranes at term.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antibiotic regimens for management of intraamniotic infection

Antibiotics are used to prevent life‐threatening complications for mother and baby when the amniotic fluid is infected, but it is not known which antibiotic is best.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Systematic Reviews in PubMed

See all (129)...

Recent Activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...