Antibiotic prophylaxis in cesarean delivery

Abstract

Introduction: In reproductive health, caesarean delivery occupies an important place, being the most common surgery in the field. The number of caesarean sections dramatically increases annually, according to the WHO, a caesarean section is recorded in 24.1% of births, in Europe and in 32.2% of total births in USA, in 2014. Although the incidence of maternal mortality and morbidity is about five times higher in caesarean section than due to vaginal birth and puerperal infections after cesarean are in 7 times more numerous than in vaginal birth. This causes a fierce need of a detailed study of puerperal infection prophylaxis according with certain indices. As well, an important issue is to avoid polypragmasy, which conditions a high increase in antibiotic’s resistance each year.Study's objective: The importance of rational use of antibiotic prophylaxis in cesarean delivery, avoiding polypragmasy. Materials and methods: A retrospective study was performed in municipal hospital Nr1, Chisinau, in three obstetrics sections (530 cases) according to questionnaire that includes specific indicators of puerperal infection and medical cards.We divided the total number of cases in two groups: first group includes women who received one dose of cephalosporin antibiotic before skin incision or after umbilical cord clamping (109 cases); in the second group are women who received several doses of antibiotics (421 cases). Statistical analysis was performed in Microsoft Excel. The data mean average value ± standard error. The veracity of difference was assessed according to criteria Student, truthful the difference p ≤ 0.05.Conclusion: For the prevention of puerperal infections after an uncomplicated cesarean delivery we should use a single dose of cephalosporin (Cefazolin 1g, intravenously) administered with 15-60 minutes before skin incision.