ISSN 2347-954X (Print) Optimal timing of peri operative antibiotics in caesarean section and risk of postpartum and neonatal infections

Abstract: The purpose of this study was to compare post partum infections and neonatal sepsis and bacteriology of cases with infections in relation to the timing of peri operative antibiotics at caesarean section. It was a prospective, Randomized Controlled Trial conducted in the Department of Obstetrics & Gynaecology, Gauhati Medical College. Group A received injectable antibiotic Ceftriaxone1gm 30-60mins before skin incision and Group B received the same antibiotic after cord clamping. Rates of post operative infections, endometritis, UTI and SSI and neonatal sepsis were compared in the two groups. In results Over a period of 12 months, 480 patients with singleton, live, term or near term pregnancies fulfilling the inclusion and exclusion criteria were included in the study (247-group A, 233-group B). Rates of endometritis (p=0.3182), UTI (p=0.4638), neonatal sepsis (p=0.8615 & 0.4919) and clinically probable sepsis (p=0.1984) were not significantly different in the two groups. However rates of SSI was significantly higher in group B. in conclusion there was no significant difference in maternal infectious morbidity and neonatal sepsis work up in relation to timing of administration of antibiotic in caesarean section, except in rates of SSI, which was more in group B. However the rates of infections were significantly higher in cases who underwent emergency caesarean (P= 0.0001), irrespective of timing of antibiotic