Prophylactic metronidazole in patients with ruptured membranes undergoing emergency caesarean section

Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section

“…In eleven studies (N = 2225), data on women undergoing an elective cesarean section were available (Adam 2005; Bagratee 2001; Duff 1982; Huam 1997; Jakobi 1994; Kolben 2001; Mahomed 1988; Rizk 1998; Shah 1998; Ujah 1992; Wu 1991). In 19 studies (N = 2229), there were data on non-elective procedures (Conover 1984; D’Angelo 1980; Elliott 1986; Freeman 1982; Fugere 1983; Gibbs 1981; Harger 1981; Hawrylyshyn 1983; Leonetti 1989; Moodley 1981; Ross 1984; Ruiz-Moreno 1991; Scarpignato 1982; Schedvins 1986; Tzingounis 1982; Weissberg 1971; Wong 1978; Work 1977; Young 1983). Three studies (N = 573) included both women having elective cesareans and non-elective cesareans (Dashow 1986; Jaffe 1984; Rothbard 1975).…”

“…Antibiotics for prophylaxis were administered intravenously either at the start of the operative procedure (“before cord”) or at or after clamping of the cord. In 36 studies (N = 5164), data on outcomes were available when the antibiotic had been administered before clamping of the cord (Adam 2005; Adeleye 1981; Allen 1972; Bibi 1994; Chan 1989; De Boer 1989; Duff 1980; Duff 1982; Freeman 1982; Gall 1979; Gerstner 1980; Gibbs 1972; Gibbs 1973; Hagglund 1989; Huam 1997; Jaffe 1984; Jaffe 1985; Kreutner 1978; Lapas 1988; Mahomed 1988; McCowan 1980: Miller 1968; Moodley 1981; Moro 1974; Morrison 1973; Ng 1992; Phelan 1979; Reckel 1985; Rehu 1980; Ross 1984; Rothbard 1975; Stage 1982; Turner 1990; Tzingounis 1982; Work 1977; Yip 1997). This was variably described as “pre-operatively”, “with induction of anaesthesia” or “before clamping of the cord”.…”