The effect of prophylactic antibiotics on risk factors for endomyometritis in adolescent patients undergoing cesarean section.

The efficacy of ticarcillin and its effect on the known risk factors for endomyometritis and the prevention of postcesarean infection was studied in adolescents. Patients were randomly given the antibiotic or a placebo. The patients who received prophylactic ticarcillin had one-half the endomyometritis rate as the placebo group. Four or more vaginal examinations during labor were associated with a high incidence of endomyometritis. This was reduced by 35% with prophylaxis. When membranes were ruptured for more than 8 hours before cesarean section, the endomyometritis rate was 86% in the placebo group, as compared to 28% in the prophylactic-treated group. A similar effect occurred in the high-risk length of labor group. Ticarcillin appears to be effective in reducing the incidence of postcesarean endomyometritis in adolescent patients. The critical risk factors, in order of importance, were the number of pelvic examinations performed during labor, the length of time between rupture of membranes and cesarean section, and the length of labor before cesarean section.