When should we perform prophylactic antibiotics in elective cesarean cases?

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Neonatal Care

Background:

• Cesarean delivery is a common surgical procedure.
• Prophylactic antibiotics are routinely administered to prevent surgical site infections.
• The optimal timing for antibiotic administration remains a subject of investigation.

Purpose of the Study:

• To evaluate the effect of prophylactic antibiotic timing on maternal and neonatal infectious morbidity following cesarean delivery.
• To compare infectious complication rates between pre-incision and post-cord clamping antibiotic administration.

Main Methods:

• Prospective, randomized trial involving 389 patients undergoing elective cesarean section.
• Group A received antibiotics before skin incision; Group B received antibiotics after umbilical cord clamping.
• Maternal infectious morbidity (endomyometritis, wound infection, febrile morbidity) and neonatal complications were assessed.

Main Results:

• No significant differences were observed in total infectious morbidity or endometritis between the two groups.
• Neonatal outcomes, including sepsis, sepsis workup, and intensive care unit admission, were comparable between groups.
• Relative risk for total infectious morbidity was 1.39 (95% CI 0.71-2.69).

Conclusions:

• The timing of prophylactic antibiotic administration in cesarean deliveries does not influence maternal infectious morbidity.
• Preoperative antibiotic prophylaxis does not adversely affect neonatal morbidity rates.