Systemic antibiotic prophylaxis in elective cesarean delivery.

OBJECTIVE

To test the value of using prophylactic antibiotics at elective cesarean delivery.

METHOD: One-hundred and twenty women delivered by elective cesarean in the absence of labor and before the rupture of membranes were randomized to receive either 1.5 g of cefuroxime intravenously at cord clamping (n = 59) or no prophylaxis (control group, n = 61).

RESULTS

Twelve women developed febrile morbidity (six study, six control, P = 0.09). Of these, five had endometritis (two study, three control, P = 0.09) and two had wound infection (one study, one control, P = 0.09). Ten more women had microbiological evidence of endometritis and wound infection (six study, four control, P = 0.08). There was no significant difference in the hospital stay (6.5 days study, 6.8 days control, P = 0.06). Staphylococcus aureus was the commonest pathogen accounting for 14 infection episodes. Amniotic fluid culture could not predict the development of infection.

CONCLUSION

Administration of prophylactic antibiotics at elective cesarean deliveries was not associated with decreased postoperative morbidity.