Infections complicating low-risk cesarean sections in community hospitals: efficacy of antimicrobial prophylaxis

Article Abstract:

Cesarean sections are a commonly performed operation in the US. Infections can complicate the period following surgery, and preventive antibiotic therapy is suggested for women at high risk for postoperative infections. It is not known whether preventive antibiotic therapy is indicated for women having low-risk cesarean sections. The effectiveness of preventive antibiotic therapy was studied in 1,863 women delivering in a community hospital. Factors predisposing low-risk cesareans to infection and the infection rate were also determined. Women having a nonurgent scheduled cesarean were considered at low risk for infection. Twenty-six (1.4 percent) of the women studied had uterine infections and 21 (1.1 percent) developed a wound infection. Of the 957 women not receiving preventive antibiotic therapy, 37 (3.7 percent) developed infections. Of the 906 women receiving antibiotic therapy, eight women (0.9 percent) developed infections. Antibiotic therapy was able to reduce the infection rate by 70 to 75 percent. Severe diarrhea, a complication of antibiotic therapy, was not observed among these study participants. It is suggested that three one-gram doses of cefazolin antibiotic can prevent serious postoperative infections after cesarean section. It is estimated that preventive antibiotic therapy can save the US $9 million per year in healthcare costs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Complications and side effects, Uterus

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Costs of triplet pregnancy

Article Abstract:

The cost of medical care for a triplet pregnancy is not prohibitive when it is considered on a per baby basis. Because New England Medicine Center is a large, tertiary care, referral hospital, enough data could be gathered over a short time period to allow a good estimate of the costs of a triplet pregnancy. Twenty triplets, resulting in 54 live-born infants, were born between July 1, 1992 and June 30, 1993. Women were admitted for bed rest only for medical indication. Stable patients were discharged for bed rest at home. All births after 25 weeks gestation were cesareans. The average gestational age at delivery was 30.2 weeks. Mothers averaged 16.7 in-patient days, and the total cost of maternal care averaged $27,491. Infants averaged 13.7 hospital days, and the average cost of infant care for the first six-weeks was $36,856. The average total cost per family was $64,347 or about $21,000 per infant. This should prove useful information for families considering in vitro fertilization.

Economic aspects, Pregnancy, Multiple, Multiple pregnancy, Triplets

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Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: a meta-analysis

Article Abstract:

Giving pregnant women antibiotics before a cesarean delivery can reduce the risk of postoperative infections even if the woman has intact membranes and a low risk of complications. This was the conclusion of researchers who reviewed seven studies covering the preoperative use of antibiotics during a cesarean.

Research

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