SynthesisThe Cochrane database of systematic reviews2014
Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth.
Synthesis in The Cochrane database of systematic reviews, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 108 citations in OpenAlex.
- Antibiotic prophylaxis for childbirth-related perineal trauma: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Clinical Outcomes of Transanal Drainage Tube Placement Following Surgical Repair for Chronic III-IV Perineal Tears.International journal of women's health · 2025Article
- Risk factors associated with severe perineal tear at Public Hospitals in Bahir Dar town, Northwest Ethiopia.SAGE open medicine · 2024Article
- Use of antibiotics in women undergoing correction of an obstetric anal sphincter injury: Results from a national Israeli survey.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Antibiotic Prescribing in Connection to Childbirth: An Observational Study in Two Districts in Lao PDR.Antibiotics (Basel, Switzerland) · 2022Article
- Incidence of postpartum infections and outcomes associated with antibiotic prophylaxis after normal vaginal birth.Frontiers in medicine · 2022Article
- Early secondary repair of obstetric anal sphincter injuries (OASIs): experience and a review of the literature.International urogynecology journal · 2021Review
- Isolated rectal buttonhole tears in obstetrics: case series and review of the literature.International urogynecology journal · 2021Review
- [Hygiene measures in antenatal care].Der Gynakologe · 2021Review
- Review of available national guidelines for obstetric anal sphincter injury.International urogynecology journal · 2020Review
- INCREASED OASIS INCIDENCE - INDICATOR OF THE QUALITY OF OBSTETRIC CARE?Acta clinica Croatica · 2019Review
- Third and Fourth Degree Perineal Tear in Four-Year Period at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.Open access Macedonian journal of medical sciences · 2018Article
- [Treatment of perineal wounds during the post partum period: evaluation of whether or not antibiotic should be systematically prescribed].The Pan African medical journal · 2017Article
Corrections and comments
- Update of
Authors and funding
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
methodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014) 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 trial reports for inclusion and risk of bias, extracted data and checked them for accuracy. MAIN
resultsWe identified and included one trial (147 women from a pre-planned sample size of 310 women) that compared the effect of prophylactic antibiotic (single-dose, second-generation cephalosporin - cefotetan or cefoxitin, 1 g intravenously) on postpartum perineal wound complications in third- or fourth-degree perineal tears compared with placebo. 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 (RR) 0.34, 95% confidence interval (CI) 0.12 to 0.96). However, the high failed-appointment rate may limit the generalisability of the results. The overall risk of bias was low except for incomplete outcome data. The quality of the evidence using GRADE was moderate for infection rate at two weeks' postpartum, and low for infection rate at six weeks' postpartum. 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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.