Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth

Prophylactic antibiotics might possibly be effective for preventing perineal wound complications following third- or fourth-degree perineal tear during vaginal birht.

Comment: The quality of evidence is downgraded by study limitations (high loss to follow-up ) and by imprecise results (only one study with few outcome events).

Summary

A Cochrane review included 1 study with a total of 147 subjects assessing the effectiveness of prophylactic antibiotic (single-dose, second-generation cephalosporin - cefotetan or cefoxitin, 1 g intravenously) on postpartum perineal wound complications in third- or fourth-degree perineal tears compared with placebo. Perineal wound complications (wound disruption and purulent discharge) at the two-week postpartum check up were 8.20% and 24.10% in the treatment and the control groups respectively (RR 0.34, 95% CI 0.12 to 0.96).

Clinical comments

Date of latest search: 31 August 2014

Ədəbiyyat

1. Buppasiri P, Lumbiganon P, Thinkhamrop J et al. Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. Cochrane Database Syst Rev 2014;(10):CD005125.