Timing of prophylactic antibiotic administration in women undergoing term caesarean section

Introduction: Caesarean section is the most common procedure performed on pregnant women globally. With increase in frequency of caesarean delivery the morbidity associated with the procedure is also increasing. The earlier practice regarding the timing of antibiotic was to administer a single dose at the time of cord clamping but now antibiotic prophylaxis is recommended within 60 minutes of the start of caesarean delivery.
The present study was undertaken to determine whether the administration of antibiotic prior to skin incision is superior to administration at the time of cord clamping for prevention of post caesarean infectious morbidity and to study the neonatal outcome in both groups.
Material & Methods: The study was conducted in the Department of Obstetrics & Gynecology, Jawaharlal Nehru Medical college, AMU, Aligarh after approval from the ethical committee of the institution. A total of 200 patients were included in this interventional experimental study. In group A (100) patients received antibiotic at the time of cord clamping and in group B(100) patients received antibiotic prior to skin incision.
Result: There was no significant difference in the incidence of fever, wound discharge, UTI, URTI, wound gaping, endometritis, rates of neonatal sepsis and NICU admission in the two groups.
Conclusion: The present study shows that there is no significant difference in the administration of prophylactic antibiotic before skin incision or at the time of cord clamping in the rates of total maternal infectious morbidity, wound infection and neonatal morbidity in terms of sepsis and NICU admission.