Antibiotic prophylaxis before vs after cord clamping during cesarean section: reflection on maternal and neonatal sepsis

ABSTRACT

To compare rate of infection among c-sectioned women who were administered a single antibiotic dose before cord claming to those administered the same dose after cord claming. To determine the rate of early and late sepsis/infection among their born infants. A randomized double blinded clinical trial of 80 women undergoing cesarean section. The study compared 2 groups of c-sectioned women, both groups were administered a single dose of Ampicilin/sublactam. Group I n=40 was administered the antibiotics before cord clamping [BCC] and group II n=40 after cord clamping [ACC]. Follow up of both mothers after delivery and their born infants continued for 6 weeks. Wound infection occurred among 5% in group I compared to 12.5% in group II, while urinary tract infection occurred among 2.5% in group I compared to 5% in group II, P=0.42 and P0.56 respectively. Two cases of positive blood cultures were detected among the ACC group compared to one case of the BCC group. A mean CRP of 4.3?3.7 was reported among infants of group I [BCC], compared to 13.8 +/- 2.5 among infants of group II [ACC], p<.05. treatment for sepsis based on clinical suspicion and pneumonia among infants born to mothers of the ACC group was more frequent compared to the BCC group. Conclusion: there was a trend of decreased rate of infection among both mothers and infants if the mothers received prophylaxis antibiotics before cord clamping during c-section