Sullivan Scott A, Smith Triz, Chang Eugene, Hulsey Thomas, Vandorsten J Peter, Soper David
Department of Obstetrics/Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA.
Am J Obstet Gynecol. 2007 May;196(5):455.e1-5. doi: 10.1016/j.ajog.2007.03.022.
The objective of the study was to determine whether the administration of cefazolin prior to skin incision was superior to administration at the time of umbilical cord clamping for the prevention of postcesarean infectious morbidity.
This was a prospective, randomized, double-blind, placebo-controlled trial. Study subjects received cefazolin 15-60 minutes prior to incision and controls received cefazolin at the time of cord clamping. The occurrence of endomyometritis, wound infection, total infectious morbidity, and neonatal complications were compared.
There were 357 subjects enrolled. No demographic differences were observed between groups. There were decreased total infectious morbidity in the study group (relative risk [RR] = 0.4, 95% confidence interval [CI] 0.18 to 0.87), decreased endometritis (RR = 0.2, 95% CI 0.15 to 0.94). No increase in neonatal sepsis (P = .99), sepsis workups (P = .96), or length of stay (P = .17) was observed.
Administration of prophylactic cefazolin prior to skin incision resulted in a decrease in both endomyometritis and total postcesarean infectious morbidity, compared with administration at the time of cord clamping. This dosing did not result in increased neonatal septic workups or complications.
本研究的目的是确定在皮肤切开前给予头孢唑林是否优于在脐带夹闭时给药，以预防剖宫产术后感染性发病。
这是一项前瞻性、随机、双盲、安慰剂对照试验。研究对象在切开前15 - 60分钟接受头孢唑林，对照组在脐带夹闭时接受头孢唑林。比较子宫内膜炎、伤口感染、总感染性发病和新生儿并发症的发生情况。
共纳入357名受试者。两组之间未观察到人口统计学差异。研究组的总感染性发病有所降低（相对风险[RR]=0.4，95%置信区间[CI]0.18至0.87），子宫内膜炎有所降低（RR = 0.2，95% CI 0.15至0.94）。未观察到新生儿败血症（P = 0.99）、败血症检查（P = 0.96）或住院时间（P = 0.17）增加。
与在脐带夹闭时给药相比，在皮肤切开前给予预防性头孢唑林可降低子宫内膜炎和剖宫产术后总感染性发病。这种给药方式并未导致新生儿败血症检查或并发症增加。
