Document Detail


Single dose cefazolin prophylaxis for postcesarean infections: before vs. after cord clamping.
MedLine Citation:
PMID:  9029389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to test the hypothesis that 1 g of cefazolin administered preoperatively is no more effective than the same dose administered after cord clamping in preventing postcesarean infectious morbidity. Ninety consecutive laboring subjects undergoing cesarean delivery at > or = 37 weeks gestation were randomized by computer to receive 1 g of cefazolin intravenously preoperatively or after cord clamping in a double-blinded, placebo-controlled study. The 2 groups were compared for differences in maternal and neonatal demographics, and intrapartum and operative characteristics associated with postcesarean infection. Primary maternal outcome variables were endometritis or wound infection. Secondary outcomes included intra-abdominal abscess formation, septic pelvic thrombophlebitis, pneumonia, or urinary tract infection. Neonatal outcomes included sepsis screens, sepsis, pneumonia, and meningitis. Subjects were followed 6 weeks postoperatively for late complications. Subjects receiving cefazolin preoperatively or after cord clamping had similar maternal and neonatal demographics, and intrapartum and operative characteristics. One patient in the former group experienced both endometritis and wound infection. In the latter group, 2 wound infections and 1 case of endometritis occurred (P = 0.35). There were no secondary maternal infections. Two infants treated for pneumonia and 2 other infants readmitted with febrile illnesses were born to mothers receiving cefazolin preoperatively. Overall, 8 neonates were evaluated for suspected sepsis and all had negative studies. Six of these infants' mothers received cefazolin preoperatively (P = 0.28). In conclusion, 1 gram of cefazolin preoperatively is no more effective than the same dose administered after cord clamping in preventing postcesarean infectious morbidity, but is associated with a trend toward increased suspected sepsis in the newborn. However, this trend may be related to differences between the study groups' risk factors for infection.
Authors:
J R Wax; K Hersey; C Philput; M S Wright; K V Nichols; M K Eggleston; J F Smith
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of maternal-fetal medicine     Volume:  6     ISSN:  1057-0802     ISO Abbreviation:  J Matern Fetal Med     Publication Date:    1997 Jan-Feb
Date Detail:
Created Date:  1997-06-19     Completed Date:  1997-06-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9211288     Medline TA:  J Matern Fetal Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  61-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, Virginia 23708, USA.
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MeSH Terms
Descriptor/Qualifier:
Bacterial Infections / drug therapy,  prevention & control*
Cefazolin / administration & dosage,  therapeutic use*
Cephalosporins / administration & dosage,  therapeutic use*
Cesarean Section*
Double-Blind Method
Female
Humans
Infant, Newborn
Postoperative Complications / drug therapy,  prevention & control*
Pregnancy
Time Factors
Umbilical Cord / blood supply,  drug effects
Chemical
Reg. No./Substance:
0/Cephalosporins; 25953-19-9/Cefazolin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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