Infection is the most common complication of cesarean delivery and can occur in 10% to 40% of women who have a cesarean compared with 1% to 3% of women who deliver vaginally. Although antibiotics have been given to women having cesareans to reduce their risk of postoperative infections, they have generally been given after the baby was born and the umbilical cord was clamped. This was based on concern that the antibiotics that made it into the baby’s bloodstream from the mother would interfere with newborn lab tests or could lead to antibiotic-resistant infections.
“Based on the latest data, prophylactic antibiotics given to pregnant women before a cesarean significantly reduce maternal infection and do not appear to harm newborns,” said William H. Barth, Jr, MD, chair of The College’s Committee on Obstetric Practice. “We’re recommending that all women who undergo cesarean get a preventive course of antibiotics before the surgery starts. Ideally, this should happen within 60 minutes of surgery.” An exception to this, Dr. Barth noted, are pregnant women who are already taking appropriate antibiotics for another problem, such as chorioamnionitis (infection of the membranes surrounding the fetus). Women who need an emergency cesarean should be given antibiotics as soon as possible.
“Anytime you have invasive surgery, you have an increased risk of developing an infection at the incision site,” said Dr. Barth. This new recommendation should help reduce the overall rate of cesarean-related infections, Dr. Barth added.
Committee Opinion #465, “Antimicrobial Prophylaxis for Cesarean Delivery: Timing of Administration,” is published in the September 2010 issue of Obstetrics & Gynecology.
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The American College of Obstetricians and Gynecologists is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 53,000 members, The American College of Obstetricians and Gynecologists strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.