IMR Press / CEOG / Volume 21 / Issue 1 / pii/1994006

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Ceftriaxone in prevention of complications after cesarean section and its influence on the newborn

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1 Clinic of Obstetrics and Gynecology University Clinical Center, Belgrade
Clin. Exp. Obstet. Gynecol. 1994, 21(1), 33–37;
Published: 10 March 1994
Abstract

The study included 303 patients subjected to elective cesarean section. Thirty two (11%) patients were classified in group A (with prophylactic ceftriaxone administration), 28 (87.5%) of whom had uneventful postoperative courses and 4 (12.5%) who had complications. Group B (with therapeutical application of ceftriaxone) was composed of 135 (45%) patents, 127 (94.1%) with uneventful postoperative courses and 8 (5.9%) with complications. Group C (in whom other antibiotics were used) consisted of 95 (31%) patients, 72 (75.8%) with uneventful postoperative courses and 23 (24.2%) with complications. Group D (no antibiotics used) was composed of 41 (13%) patients, 31 (75.6%) with uneventful postoperative courses and 10 (24.4%) with complications. Statistical analysis revealed highly significant differences in distribution of complications according to whether any, and which one of the antibiotics was used (X2 = 17.81, p < 0.005). This difference mainly resulted from lower incidence of complications associated with ceftriaxone use than in patients with no antibiotic therapy (X2 = 11.66; p < 0.005) as well as in patients using other antibiotics (X2 = 15.95; p < 0.005). Significant difference was also noted when patients given antibiotics other than ceftriaxone were compared with patients receiving no antibiotics other than ceftriaxone were compared with patients receiving no antibiotic therapy (X2 = 4.45; p < 0.05). Group A of newborns included 17 (89.5%) with high Apgar score, while 2 children (10.5%) had the score below 8. Group B had 2 children (11.7%) with Apgar score below 8, while 15 (88.3%) children had higher scores. The acid-base balance of the children was also evaluated: Group A had the mean Ph of 7.26 (SD = 0.06) and group B had 7.27 (SD = 0.05). Statistical evaluation revealed no significant difference between the two values (X2 = 0.02; t = 0.22 p > 0.05). Bacteriological studies revealed presence of bacteria in 6 (35%) of newborns in group B and in none from group A. Statistical analysis revealed significance of the difference (X2 = 1.97; p < 0.05). Nevertheless, WBC count was lower in group A: 18.95 × 109/1 (SD = 11 94) than in group B: 28.29 109/1 (SD = 7.21), and the difference was highly significant (t = -2.79; p < 0.001). Bilirubin values were lower in group A: 126.4 (SD = 52.3) than in group B: 208.1 (SD = 22.01), and the difference was significant (p < 0.001; t = 5.96). In this situation, a ceftriaxone dose of 1 g 12 hrs before the surgery significantly reduced incidence of infections after cesarean section. Besides, no adverse effects on the fetus were noted; due to its efficacy, safety and convenience, a single preoperative usage of ceftriaxone has a role in prevention of infections after cesarean section.

Keywords
Prophylactic ceftriaxone
Elective cesarean section
Effects on newborns
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