Single dose cefazolin prophylaxis for postcesarean infections

Before vs. after cord clamping

Joseph R. Wax, Kelly Hersey, Christine Philput, Mark S. Wright, Katharine V. Nichols, M. K. Eggleston, James Smith, Jr.

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

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 ≥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.

Original languageEnglish
Pages (from-to)61-65
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume6
Issue number1
StatePublished - Jan 1997

Fingerprint

Cefazolin
Constriction
Mothers
Endometritis
Sepsis
Wound Infection
Infection
Pneumonia
Demography
Newborn Infant
Abdominal Abscess
Morbidity
Thrombophlebitis
Coinfection
Meningitis
Urinary Tract Infections
Fever
Placebos
Pregnancy

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Wax, J. R., Hersey, K., Philput, C., Wright, M. S., Nichols, K. V., Eggleston, M. K., & Smith, Jr., J. (1997). Single dose cefazolin prophylaxis for postcesarean infections: Before vs. after cord clamping. Journal of Maternal-Fetal and Neonatal Medicine, 6(1), 61-65.

Single dose cefazolin prophylaxis for postcesarean infections : Before vs. after cord clamping. / Wax, Joseph R.; Hersey, Kelly; Philput, Christine; Wright, Mark S.; Nichols, Katharine V.; Eggleston, M. K.; Smith, Jr., James.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 6, No. 1, 01.1997, p. 61-65.

Research output: Contribution to journalArticle

Wax, JR, Hersey, K, Philput, C, Wright, MS, Nichols, KV, Eggleston, MK & Smith, Jr., J 1997, 'Single dose cefazolin prophylaxis for postcesarean infections: Before vs. after cord clamping', Journal of Maternal-Fetal and Neonatal Medicine, vol. 6, no. 1, pp. 61-65.
Wax JR, Hersey K, Philput C, Wright MS, Nichols KV, Eggleston MK et al. Single dose cefazolin prophylaxis for postcesarean infections: Before vs. after cord clamping. Journal of Maternal-Fetal and Neonatal Medicine. 1997 Jan;6(1):61-65.
Wax, Joseph R. ; Hersey, Kelly ; Philput, Christine ; Wright, Mark S. ; Nichols, Katharine V. ; Eggleston, M. K. ; Smith, Jr., James. / Single dose cefazolin prophylaxis for postcesarean infections : Before vs. after cord clamping. In: Journal of Maternal-Fetal and Neonatal Medicine. 1997 ; Vol. 6, No. 1. pp. 61-65.
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