Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant

Amita Ray, Sujoy Ray

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Background: Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen the emergence of a variety of other methods of induction of labour but amniotomy combined with oxytocin infusion remains the most commonly used method of augmentation of labour. The newer agents for induction are expensive and in resource-poor settings amniotomy is still the chosen method for both induction and augmentation. As with any invasive procedure amniotomy can lead to infection, ascending from the vagina into the uterine cavity and can contribute significantly to both maternal and neonatal infectious morbidity. Objectives: The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014). Selection criteria: Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy versus placebo (or no treatment) were eligible for inclusion in this review but none were identified. Quasi-randomised trials or cross-over trials were not eligible for inclusion. Data collection and analysis: Two review authors independently assessed one trial report for inclusion. In future updates of this review, two review authors will independently assess risk of bias and carry out data extraction. Data will be checked for accuracy. Main results: We identified one trial report but this was excluded. No studies met the inclusion criteria for this review. Authors' conclusions: High-quality trials are needed to justify or refute the routine use of antibiotics at amniotomy for prevention of infection in the mother and infant. Future studies should be conducted, especially in resource-constrained settings where amniotomy is still used as a means of induction of labour, in order to evaluate the routine use of antibiotics at amniotomy in these settings. Future research in this area should include important maternal and infant outcomes listed in this review and also consider cost effectiveness and side effects of antibiotic use, including the emergence of antibiotic-resistant strains.

Original languageEnglish
Article numberCD010626
JournalCochrane Database of Systematic Reviews
Volume2014
Issue number10
DOIs
Publication statusPublished - 01-10-2014
Externally publishedYes

Fingerprint

Induced Labor
Mothers
Anti-Bacterial Agents
Morbidity
Placebos
Pregnancy Complications
Vagina
Oxytocin
Infection
Cross-Over Studies
Patient Selection
Obstetrics
Cost-Benefit Analysis
Registries
Rupture
Randomized Controlled Trials
Clinical Trials
Parturition
Pregnancy
Membranes

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

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title = "Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant",
abstract = "Background: Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen the emergence of a variety of other methods of induction of labour but amniotomy combined with oxytocin infusion remains the most commonly used method of augmentation of labour. The newer agents for induction are expensive and in resource-poor settings amniotomy is still the chosen method for both induction and augmentation. As with any invasive procedure amniotomy can lead to infection, ascending from the vagina into the uterine cavity and can contribute significantly to both maternal and neonatal infectious morbidity. Objectives: The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014). Selection criteria: Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy versus placebo (or no treatment) were eligible for inclusion in this review but none were identified. Quasi-randomised trials or cross-over trials were not eligible for inclusion. Data collection and analysis: Two review authors independently assessed one trial report for inclusion. In future updates of this review, two review authors will independently assess risk of bias and carry out data extraction. Data will be checked for accuracy. Main results: We identified one trial report but this was excluded. No studies met the inclusion criteria for this review. Authors' conclusions: High-quality trials are needed to justify or refute the routine use of antibiotics at amniotomy for prevention of infection in the mother and infant. Future studies should be conducted, especially in resource-constrained settings where amniotomy is still used as a means of induction of labour, in order to evaluate the routine use of antibiotics at amniotomy in these settings. Future research in this area should include important maternal and infant outcomes listed in this review and also consider cost effectiveness and side effects of antibiotic use, including the emergence of antibiotic-resistant strains.",
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Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. / Ray, Amita; Ray, Sujoy.

In: Cochrane Database of Systematic Reviews, Vol. 2014, No. 10, CD010626, 01.10.2014.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant

AU - Ray, Amita

AU - Ray, Sujoy

PY - 2014/10/1

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N2 - Background: Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen the emergence of a variety of other methods of induction of labour but amniotomy combined with oxytocin infusion remains the most commonly used method of augmentation of labour. The newer agents for induction are expensive and in resource-poor settings amniotomy is still the chosen method for both induction and augmentation. As with any invasive procedure amniotomy can lead to infection, ascending from the vagina into the uterine cavity and can contribute significantly to both maternal and neonatal infectious morbidity. Objectives: The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014). Selection criteria: Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy versus placebo (or no treatment) were eligible for inclusion in this review but none were identified. Quasi-randomised trials or cross-over trials were not eligible for inclusion. Data collection and analysis: Two review authors independently assessed one trial report for inclusion. In future updates of this review, two review authors will independently assess risk of bias and carry out data extraction. Data will be checked for accuracy. Main results: We identified one trial report but this was excluded. No studies met the inclusion criteria for this review. Authors' conclusions: High-quality trials are needed to justify or refute the routine use of antibiotics at amniotomy for prevention of infection in the mother and infant. Future studies should be conducted, especially in resource-constrained settings where amniotomy is still used as a means of induction of labour, in order to evaluate the routine use of antibiotics at amniotomy in these settings. Future research in this area should include important maternal and infant outcomes listed in this review and also consider cost effectiveness and side effects of antibiotic use, including the emergence of antibiotic-resistant strains.

AB - Background: Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen the emergence of a variety of other methods of induction of labour but amniotomy combined with oxytocin infusion remains the most commonly used method of augmentation of labour. The newer agents for induction are expensive and in resource-poor settings amniotomy is still the chosen method for both induction and augmentation. As with any invasive procedure amniotomy can lead to infection, ascending from the vagina into the uterine cavity and can contribute significantly to both maternal and neonatal infectious morbidity. Objectives: The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014). Selection criteria: Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy versus placebo (or no treatment) were eligible for inclusion in this review but none were identified. Quasi-randomised trials or cross-over trials were not eligible for inclusion. Data collection and analysis: Two review authors independently assessed one trial report for inclusion. In future updates of this review, two review authors will independently assess risk of bias and carry out data extraction. Data will be checked for accuracy. Main results: We identified one trial report but this was excluded. No studies met the inclusion criteria for this review. Authors' conclusions: High-quality trials are needed to justify or refute the routine use of antibiotics at amniotomy for prevention of infection in the mother and infant. Future studies should be conducted, especially in resource-constrained settings where amniotomy is still used as a means of induction of labour, in order to evaluate the routine use of antibiotics at amniotomy in these settings. Future research in this area should include important maternal and infant outcomes listed in this review and also consider cost effectiveness and side effects of antibiotic use, including the emergence of antibiotic-resistant strains.

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