scholarly journals A prospective randomised clinical trial of prophylactic antibiotic in caesarean delivery and fetomaternal outcome

2018 ◽  
Vol 7 (2) ◽  
pp. 639
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Pragnya Paramita Nayak ◽  
Sudakshina Panja ◽  
Shritanu Bhattacharyya ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Umbilical Cord ◽  
Caesarean Delivery ◽  
Prophylactic Antibiotic ◽  
Skin Incision ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Study Group ◽  
Cord Clamping ◽  
Umbilical Cord Clamping

Background: Infectious maternal and perinatal morbidities are 5 to 20 times more in caesarean section when compared to vaginal births. Objective of present study was to assess the rates of maternal and neonatal infectious morbidities following administration of antibiotic before skin incision compared to given after umbilical cord clamping during caesarean delivery.Methods: 185 pregnant women with gestational periods more than 34 weeks who were prepared for caesarean delivery, randomized to single dose antibiotic given either before skin incision (study group) or after umbilical cord clamping (control group). Primary outcome measures: maternal postoperative infections morbidities. Secondary outcome measures: neonatal infections morbidities with Sick Newborn Care Unit (SNCU) admissions and postoperative hospital stay of mother.Results: Surgical Site Infections (SSI) and postoperative fever were significantly less in the study group than the control group so also the lesser incidences of endometritis but no statistically significant difference in the incidence of peritonitis and wound dehiscence were observed in both groups. No significant differences were seen in neonatal infectious morbidities and SNCU admission when compared in both groups. There was significantly less mean postoperative hospital stay of mothers in the group who received prophylactic antibiotic pre-incision.Conclusions: Antibiotic given 30-60 minutes before skin incision significantly decreases maternal postoperative infectious morbidities barring neonate.

scholarly journals Influence of timing of maternal antibiotic administration during caesarean section on infant microbial colonisation: a randomised controlled trial

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324767
Author(s):  
Thomas Dierikx ◽  
Daniel Berkhout ◽  
Anat Eck ◽  
Sebastian Tims ◽  
Johan van Limbergen ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Caesarean Section ◽  
Umbilical Cord ◽  
Controlled Trial ◽  
Skin Incision ◽  
Control Group ◽  
Antibiotic Administration ◽  
Cord Clamping ◽  
Umbilical Cord Clamping ◽  
Randomised Controlled

ObjectiveRevised guidelines for caesarean section (CS) advise maternal antibiotic administration prior to skin incision instead of after umbilical cord clamping, unintentionally exposing the infant to antibiotics antenatally. We aimed to investigate if timing of intrapartum antibiotics contributes to the impairment of microbiota colonisation in CS born infants.DesignIn this randomised controlled trial, women delivering via CS received antibiotics prior to skin incision (n=20) or after umbilical cord clamping (n=20). A third control group of vaginally delivering women (n=23) was included. Faecal microbiota was determined from all infants at 1, 7 and 28 days after birth and at 3 years by 16S rRNA gene sequencing and whole-metagenome shotgun sequencing.ResultsCompared with vaginally born infants, profound differences were found in microbial diversity and composition in both CS groups in the first month of life. A decreased abundance in species belonging to the genera Bacteroides and Bifidobacterium was found with a concurrent increase in members belonging to the phylum Proteobacteria. These differences could not be observed at 3 years of age. No statistically significant differences were observed in taxonomic and functional composition of the microbiome between both CS groups at any of the time points.ConclusionWe confirmed that microbiome colonisation is strongly affected by CS delivery. Our findings suggest that maternal antibiotic administration prior to CS does not result in a second hit on the compromised microbiome. Future, larger studies should confirm that antenatal antibiotic exposure in CS born infants does not aggravate colonisation impairment and impact long-term health.

scholarly journals Effects of umbilical cord milking on premature neonates’ and mothers’ outcomes

2019 ◽  
Vol 9 (11) ◽  
pp. 1
Author(s):  
Nahed Thabet Mohamed ◽  
Atyat Mohammed Hassan ◽  
Heba Mostafa Mohamed ◽  
Amal A. Abdelhafez ◽  
Eman Abd Elaziz Mohamed ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Umbilical Cord ◽  
Length Of Hospital Stay ◽  
Structured Interview ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Premature Neonates ◽  
Umbilical Cord Milking

Background: Umbilical Cord Milking (UCM) is a safe and likely technique for both the mothers and their neonates which improve the neonatal outcomes. The aim of the study was to assess the effects of umbilical cord milking on premature neonates' and mothers' outcomes.Methods: Design: Quasi-experimental research design was utilized. Setting: Emergency and Labor Unit of Women's Health University Hospital and Neonatal Intensive Care Unit (NICU) in Assiut University Children Hospital were the setting which the study was implemented. Subjects: It included 80 mothers and their premature neonates. The subjects were divided randomly into two groups (40 premature neonates who were received the UCM as a study group and 40 premature neonates as a control group who received the Immediate Cord Clamping [ICC]). Tool: One structured interview questionnaire was designed especially for this study. It included two parts: Personal and clinical data of the studied mothers and premature neonates.Results: The Hemoglobin (Hb) level significantly increased in the study group when compared to the control group within 6 hours of birth (12.11 vs. 10.61) and at 36-48 hours after UCM (12.27 vs. 11.32). Also, UCM had significantly improved the need for blood transfusion, death rate, and length of hospital stay among premature neonates in the study group.Conclusions and recommendations: UCM improved preterm neonates' outcomes as increasing Hb level, less need for blood transfusion, and decline incidence of death, lowers length of hospital stay. Recommendations: Increasing awareness of neonatology, pediatric, and obstetric nurses about benefits and technique of UCM through health education program.

scholarly journals The Impact of Umbilical Cord Clamping Time on the Infant Anemia: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sevil Güner ◽  
Birsen Karaca Saydam
Keyword(s):  
Randomized Controlled Trial ◽  
Umbilical Cord ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Cord Clamping ◽  
Significant Difference ◽  
Umbilical Cord Clamping ◽  
The Impact

Background: Anemia during infancy causes irreversible physical, cognitive, motor, and behavioral development disorders. This study aimed to determine the effect of delaying umbilical cord clamping time on certain parameters regarding anemia during the infancy. Methods: This randomized controlled trial was conducted at a university hospital in west of Turkey (Dec 2017- Dec 2018). Overall, 110 participants were evaluated for the research, 65 participants were randomized after excluding those who did not meet the inclusion criteria (intervention=32, control=33). Randomly assigned to delayed clamping (1 min after delivery) or early clamping (in 15 sec after delivery), and followed up until 4 months postpartum. 48th-hour hematocrit, bilirubin values, need for phototherapy and hematocrit, hemoglobin values, diagnosis of anemia at the postnatal fourth month were compared between two groups. The data showing normal distribution were assessed using the parametric tests. The level of statistical significance was determined as P<0.05. Results: The 48th-hour hematocrit and bilirubin levels of the intervention group were significantly higher than the control (P<0.01 and P<0.05, respectively). No significant difference regarding the need for phototherapy due to postnatal hyperbilirubinemia was observed between the two groups (P>0.05). Means of the intervention group hematocrit and hemoglobin levels measured during anemia screening performed at the fourth month were found to be higher than those of the infants in the control group (P<0.05 and P<0.05, respectively). Conclusion: Delaying umbilical cord clamping had a positive impact on the haematological parameters of infants. Clamping the cord at least one minute in birth can be performed to prevent the iron deficit anemia that could be seen during the first years of infants’ lives.

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