Effect of Post Episiotomy Antibiotic on Maternal Infectious Morbidity(Clinical trial)

Abstract

AbstractBackground: Episiotomy is a surgical wound done with sterile scissors to widen the vaginal opening. There is little information on the prevalence of post-episiotomy infection worldwide. Contrary to WHO recommendations, prophylactic antibiotics still prescribed in many hospitals including our hospital, to prevent the episiotomy site infection in all women after childbirth.Aim: To compare infectious morbidity rate between parturient women with uncomplicated vaginal birth received either prophylactic course of oral antibiotics post-episiotomy in addition to routine local care and who received routine local care only.Patient and method: A randomized trial conducted in the labour room of Alzhraa University Hospital, Cairo, Egypt within a 15 months duration. We recruited 630 pregnant ladies admitted for a non-complicated vaginal birth and indicated for episiotomy. Cases randomly assigned after delivery and at discharge into two groups. Group A: prescribed on discharge oral antibiotics twice daily for 5 days after the delivery and routine episiotomy care, Group B: received routine episiotomy care only. Primary outcomes: Episiotomy wound infection and endometritis, and secondry outcomes: Episiotomy wound dehiscence or gapping, Puerperal infection or adverse effects of antibiotics.Results: We reported a 7.5 % prevalence of wound infection in total study participants. Episiotomy overall wound complications were 7.8 %-6.7% in antibiotic and non antibiotic group respectively with no statistical difference. On the second visit, no cases reported with abnormal lochia or maternal fever.Conclusion: It is concluded that administration of prophylactic systemic antibiotic post episiotomy is not effective to prevent wound infection.