Antibiotics to protect against sepsis?
Many women experience painful and occasionally life-threatening infections after giving birth to their child. Preventive antibiotic treatment could save affected women from such problems.
A recent study by the internationally recognized University of Oxford found that preventive antibiotic treatment can protect women from dangerous infections after assisted delivery. The results of the study were published in the English language journal "The Lancet".
More than 3,400 women participated in the study
The current study included 3,420 women who had given birth to children in 27 different facilities across the UK. A single dose of antibiotics within six hours of childbirth halved the number of infections in women whose babies were born using either special tweezers or a suction cup.
Findings could prevent more than 200,000 infections each year
The findings could lead to the prevention of more than 200,000 maternal infections worldwide each year. Already this year, they will be considered in new recommendations published by the British Royal College of Obstetricians and Gynecologists. This will have a huge impact on women, not just the infection rate. Those women who received antibiotics were also much less likely to experience perineal pain and burst sutures. As a result, the women affected had fewer problems feeding their baby despite the pain.
Why does the risk of infection increase with assisted births?
Using forceps and suction cups at birth can increase the risk of infection by getting microbes into the genital tract. Women with assisted childbirth are usually in labor for longer, have more frequent vaginal examinations, are more often equipped with urinary catheters, suffer more often from pain and need surgery more often than women who give birth naturally and spontaneously. These factors can all increase the risk of infection, which in rare cases can even lead to life-threatening sepsis, the researchers explain. In developed countries, about one in 20 maternal deaths is due to infection. For every fatal infection, another 70 women develop infections that are serious enough to cause long-term health problems.
How did preventive antibiotic treatment work?
Between March 2016 and June 2018, women at random received either an antibiotic (amoxicillin and clavulanic acid) or a saline placebo that was given intravenously within six hours of birth. So-called suction cups were used in a third of the births and special tweezers were used in two thirds. In the placebo group, 19 percent of women had an infection shortly after birth, compared to 11 percent in the antibiotic group. More serious cases of sepsis, confirmed by a positive blood test, occurred in 1.5 percent of the mothers in the placebo group. Of the women treated with antibiotics, only 0.6 percent had sepsis. The high proportion of women with an infection was surprising. Most of them were not serious, life-threatening infections, but they had to be treated to ensure that they did not lead to serious life-threatening infections, the researchers explain.
Treatment reduces overall antibiotic consumption
Protecting women from infection immediately after delivery also reduced overall antibiotic consumption. For every 100 doses of antibiotics given prophylactically, physicians had to give 168 fewer doses for infections after birth. The lower infection rate among women who were given antibiotics had a positive effect on overall recovery after birth, according to the study. Compared to the placebo group, women taking antibiotics were less likely to be treated for burst sutures and perineal pain. These women also required fewer home visits or outpatient appointments due to their wounds. It is common practice to give a single dose of antibiotic to all women who need a caesarean section to reduce the infection. This should therefore also be considered for women after an assisted birth, the researchers report. Routine single-dose antibiotic use after assisted delivery can help reduce infections and reduce the cost of healthcare complications. (as)