Infections following cesarean section.
Postpartum endomyometritis and abdominal wound infection remain the most common infectious complications following childbirth. New information now suggests that incipient infection of the myometrium explains why patients develop postpartum endometritis despite antibiotic prophylaxis. Clinical predictors of postpartum endometritis continue to suffer from low sensitivity. However, use of a Gram stain of the amniotic fluid may be helpful in identifying a subset of women that may benefit from a therapeutic course of antibiotics initiated immediately after cesarean section. Broad-spectrum antimicrobial therapy is the mainstay of therapy for postpartum endometritis. Two newer extended spectrum cephalosporins, cefotetan and ceftizoxime, appear to be as effective as cefoxitin in the treatment of these infections. Abdominal wound infection is a common cause of antimicrobial failure in patients treated for post-cesarean endomyometritis. The genital mycoplasmas, usually resistant to the penicillins and cephalosporins, are commonly isolated from infected wounds following cesarean section. Wound infection surveillance has been shown to decrease infection incidence rates by providing feedback to the operating surgeon.
Soper
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Department of Obstetrics and Gynecology, Medical College of Virginia, Virginia Commonwealth University, Richmond.
D000900:Anti-Bacterial Agents; D002585:Cesarean Section / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004716:Endometritis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D011247:Pregnancy; D011292:Premedication; D011645:Puerperal Infection / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control
D000900:Anti-Bacterial Agents