>Antibiotic Prophylaxis for Operative Vaginal Delivery.

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Date: Oct. 1, 2020
From: American Family Physician(Vol. 102, Issue 7)
Publisher: American Academy of Family Physicians
Document Type: Medical condition overview
Length: 822 words
Lexile Measure: 2010L

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Study Population: Women who underwent operative vaginal delivery

Efficacy End Points: Reduction in infectious postpartum morbidities such as wound infection, wound breakdown, endometritis, and sepsis in women with less than a third-degree tear (antibiotics are commonly administered for third- or fourth-degree tears)

Harm End Points: Adverse reaction to antibiotic therapy

Narrative: Operative vaginal birth is used to achieve or expedite safe delivery for maternal or fetal indications, and is accomplished using traction on the fetal head through the application of forceps or a vacuum extractor. (1) Despite success in achieving vaginal birth, operative vaginal deliveries may result in an increased incidence of postpartum infections and maternal readmissions when compared with spontaneous vaginal deliveries. (2) Despite these potential complications, current guidelines from the World Health Organization do not recommend routine antibiotic prophylaxis for operative vaginal birth because of insufficient evidence of effectiveness. (3)

This Cochrane review included two randomized controlled trials with a total of 3,813 pregnant women undergoing operative vaginal delivery using a vacuum or forceps. (2)

The ANODE trial was a blinded, randomized, multicenter trial conducted in the United Kingdom that consisted of 3,420 women. The trial compared a single dose of intravenous amoxicillin/ clavulanate (Augmentin) with placebo. (2) The...

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Gale Document Number: GALE|A636428616