SynthesisThe Cochrane database of systematic reviews2010
Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth.
Synthesis in The Cochrane database of systematic reviews, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
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0 citing papers in PubMed, 14 citations in OpenAlex.
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4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOne to eight per cent of women suffer third-degree perineal tear (anal sphincter injury) and fourth-degree perineal tear (rectal mucosa injury) during vaginal birth, and these tears are more common after forceps delivery (28%) and midline episiotomies. Third- and fourth-degree tears can become contaminated with bacteria from the rectum and this significantly increases in the chance of perineal wound infection. Prophylactic antibiotics might have a role in preventing this infection.
objectivesTo assess the effectiveness of antibiotic prophylaxis for reducing maternal morbidity and side effects in third- and fourth-degree perineal tear during vaginal birth. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2010) and the reference lists of retrieved articles. SELECTION CRITERIA: Randomised controlled trials comparing outcomes of prophylactic antibiotics versus placebo or no antibiotics in third- and fourth-degree perineal tear during vaginal birth. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the reports and extracted data. MAIN
resultsWe identified and included one trial (147 participants) that compared the effect of prophylactic antibiotic (single-dose, second generation cephalosporin, intravenously) on postpartum perineal wound complications in third- or fourth-degree perineal tears. Perineal wound complications (wound disruption and purulent discharge) at the two-week postpartum check up were 8.20% and 24.10% in the treatment and the control groups respectively (risk ratio 0.34, 95% confidence interval 0.12 to 0.96). AUTHORS'
conclusionsAlthough the data suggest that prophylactic antibiotics help to prevent perineal wound complications following third- or fourth-degree perineal tear, loss to follow-up was very high. The results should be interpreted with caution as they are based on one small trial.
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