[Bacteremia induced by labor. Is prophylaxis for infective endocarditis necessary?].
OBJECTIVE
To characterize the occurrence of bacteremia during delivery and to verify the necessity of prophylaxis against infective endocarditis.


METHODS
The authors collected hemoculture of 100 women, 15,30 and 45 minutes after delivery. The data were collected from May 1992 until May 1993. The positive hemocultures were followed by antibiogram.


RESULTS
Seven hemocultures were positive: six for Staphylococcus, one for Candida sp, Penicilium sp, Clandosporum sp and Aspergillus sp that were found in association. Four patients had prematures amniorrhexis, longer than 6 hours before delivery (p < 0.05). Six patients had labor longer than 6 hours after admission (p < 0.05). The authors did not observe differences related to vaginal delivery with or without forceps or cesarean section. The samples were all sensible to cefalotin at the antibiogram.


CONCLUSIONS
Labor and delivery is a high risk procedure for bacteremia and so for ineffective endocarditis in susceptible patients. The statistical analysis recognize as risk factors labor longer than 6 hours inside the hospital and premature amniorrhexis. We propose the use of intravenous cefalotin 1g 60 minutes before expulsion and repeated 6 and 12 hours later.
Tiossi
C L
CL
Faculdade de Ciências Médicas da Santa Casa de São Paulo.
Rodrigues
F O
FO
Santos
A R
AR
Franken
R A
RA
Mimica
L
L
Tedesco
J J
JJ
D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000382:microbiology* / Q000517:prevention & control; D001938:Brazil / Q000453:epidemiology; D002512:Cephalothin / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
D002512:Cephalothin
Bacteremia induzida pelo trabalho de parto. Cabe a profilaxia da endocardite infecciosa?