Effect of Maternal Obesity on Maternal-Fetal Transfer of Preoperative Cefazolin at Cesarean Section

Groff, Stephanie McKenney; Fallatah, Wareef; Yang, Samuel; Murphy, Jamie; Crutchfield, Christopher A.; Marzinke, Mark A.; Kurtzberg, Joanne; Lee, Carlton K. K.; Burd, Irina; Farzin, Azadeh

doi:10.5863/1551-6776-22.3.227

Cited by 13 publications

(26 citation statements)

References 31 publications

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“…Cefazolin rapidly crosses the placenta and is detected in cord blood and amniotic fluid at levels above the GBS MIC within 20 minutes after maternal administration. [67][68][69][70] Clindamycin is recommended for GBS IAP for women with a penicillin allergy who are at high risk for anaphylaxis and who are colonized with GBS known to be susceptible to clindamycin. 7 Group B streptococci are increasingly resistant to clindamycin as well as to macrolide antibiotics such as erythromycin.…”

Section: Alternative Antibiotics For Gbs Iapmentioning

confidence: 99%

Management of Infants at Risk for Group B Streptococcal Disease

et al. 2019

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Group B streptococcal (GBS) infection remains the most common cause of neonatal early-onset sepsis and a significant cause of late-onset sepsis among young infants. Administration of intrapartum antibiotic prophylaxis is the only currently available effective strategy for the prevention of perinatal GBS earlyonset disease, and there is no effective approach for the prevention of late-onset disease. The American Academy of Pediatrics joins with the American College of Obstetricians and Gynecologists to reaffirm the use of universal antenatal microbiologic-based testing for the detection of maternal GBS colonization to facilitate appropriate administration of intrapartum antibiotic prophylaxis. The purpose of this clinical report is to provide neonatal clinicians with updated information regarding the epidemiology of GBS disease as well current recommendations for the evaluation of newborn infants at risk for GBS disease and for treatment of those with confirmed GBS infection. This clinical report is endorsed by the American College of Obstetricians and Gynecologists (ACOG), July 2019, and should be construed as ACOG clinical guidance. The Centers for Disease Control and Prevention (CDC) first published consensus guidelines on the prevention of perinatal group B streptococcal (GBS) disease in 1996. These guidelines were developed in collaboration with the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives, the American Academy of Family Physicians, and other stakeholder organizations 1 on the basis of available evidence as well as expert opinion. The 1996 consensus guidelines recommended either an antenatal culture-based or risk factor-based approach for the administration of intrapartum antibiotic prophylaxis (IAP) to prevent invasive neonatal GBS early-onset disease (EOD). 1 The guidelines were updated in 2002 primarily on the basis of new data from a CDC multistate retrospective cohort study in which authors found universal screening for group B streptococci (Streptococcus agalactiae) was .50% more effective at preventing the disease compared to a risk-based approach. 2,3 In 2010,

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Section: Alternative Antibiotics For Gbs Iapmentioning

confidence: 99%

Management of Infants at Risk for Group B Streptococcal Disease

et al. 2019

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“…Eventually, a total of 40 relevant articles [ 10 , 11 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ] were included in the current systematic literature review whereas 21 articles provided data for meta-analysis. Six studies regarding skin incision [ 24 , 26 , 27 , 31 , 33 , 42 ] and 9 studies regarding drainage [ 21 , 22 , 23 , 24 , 25 , 27 , 32 , 35 , 46 ] were performed in meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Wound Complications after a Caesarean Section in Obese Women

Słabuszewska-Jóźwiak

Szymański

Jóźwiak

et al. 2021

JCM

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(1) Background: Caesarean sections in obese patients are associated with an increased risk of surgical wound complications, including hematomas, seromas, abscesses, dehiscence, and surgical site infections. The aim of the present study is to perform a meta-analysis and systematic review of the current literature focusing on the strategies available to decrease wound complications in this population. (2) Methods: We reviewed the data available from the PubMed and the Science Direct databases concerning wound complications after caesarean sections in obese women. The following key words were used: “caesarean section”, “cesarean section”, “wound complication”, “wound morbidity”, and “wound infection”. A total of 540 papers were retrieved, 40 of which were selected for the final systematic review and whereas 21 articles provided data for meta-analysis. (3) Results: The conducted meta-analyses revealed that the use of prophylactic drainage does not increase the risk of wound complications in obese women after a caesarean sections (pooled OR = 1.32; 95% CI 0.64–2.70, p = 0.45) and that vertical skin incisions increase wound complications (pooled OR = 2.48; 95% CI 1.85–3.32, p < 0.01) in obese women, including extremely obese women. (4) Conclusions: Subcutaneous drainage does not reduce the risk of a wound complications, wound infections, and fever in obese women after caesarean sections. Negative prophylactic pressure wound therapy (NPWT) may reduce the risk of surgical site infections. The evidence of using a prophylactic dose of an antibiotic before the caesarean section is still lacking.

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“…However, it is unclear if there is any advantage of one antibiotic over another, both in terms of choice of drug and dosage, in obese women undergoing CS. (1)(2)(3)(4) The prevalence of maternal obesity varies across the UK; in the East of England, the rate is 6.23%, whilst in London 3.46% are obese (5). The rate of CS in the obese population is 33.8% rising to 47.4% in class II or III obesity(6).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of perioperative cefuroxime as a prophylactic antibiotic in women requiring caesarean section: A systematic review

Alrammaal

Batchelor

Morris

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

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Effect of Maternal Obesity on Maternal-Fetal Transfer of Preoperative Cefazolin at Cesarean Section

Abstract: Administration of 2 g of cefazolin to women undergoing scheduled C/S might be an adequate prophylactic dose for surgical wound infection in both non-obese and obese patients; and cefazolin concentration in fetal circulation may be protective against GBS and S aureus.

Cited by 13 publications

References 31 publications

Management of Infants at Risk for Group B Streptococcal Disease

Management of Infants at Risk for Group B Streptococcal Disease

A Systematic Review and Meta-Analysis of Wound Complications after a Caesarean Section in Obese Women

Efficacy of perioperative cefuroxime as a prophylactic antibiotic in women requiring caesarean section: A systematic review

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