الفهرس 
Indications of Cesarean SectionOnly 14 pages are availabe for public view
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Abstract
The prophylactic use of antibiotics in many obstetric-gynecologic procedures, particularly non¬elective cesarean delivery, is well established in clinical practice. Short-course antibiotic prophylaxis in women undergoing non-elective cesarean delivery reduces both endometritis and wound infections.
Routine prophylaxis is controversial for elective cesarean delivery. Even low-risk cesarean deliveries carry an appreciable risk therefore the role of antibiotic prophylaxis in elective cesarean delivery was thoroughly investigated and there is a large body of literature supports the prophylactic use of antibiotics in elective cesarean delivery.
In the extensive body of literature on prophylactic antibiotic use for decreasing postoperative infection among laboring patients undergoing cesarean delivery, vaginal hysterectomy, or abdominal hysterectomy, a huge number of different antibiotics have been studied. A protective effect was nearly always demonstrated. This seems to suggest that any broad spectrum antibiotic is effective in clean and non contaminated cases, and choice should therefore be based on such other factors as cost and the wound site and expected flora and pathogens.
The current study was conducted in the Department of Obstetrics, Elbalyan general hospital Sohage during the period from June 2009 through to January 2010. The study included a total of 200 women who underwent elective cesarean section. Participants were randomized into 2 groups (each group 100 women) according to the regimen of prophylactic antibiotic used. The antibiotic regimens were as follow:
• Group A: were received 2 gm cefotaxime sodium preoperative (from 15-30 minutes) and (500mg metronidazole as rectal suppositories evry 12 hours+azithromycin 500 mg once daily) postoperative for 3 consecutive days
• Group B: were received 2 gm cefotaxime sodium atfter cord clamping and (500mg metronidazole as rectal suppositories evry 12 hours+azithromycin 500 mg once daily) post-operative for 3 consecutive days.An informed written consent was taken from every woman participating in the study.
In group (A) there were 6% of cases had postoperative infectious complications in the form of urinary tract and wound infections. 4% of them had both wound and urinary tract infections and 2% had only wound infection.
And in group (B) there were 8% of cases had post-operative infectious complications in the form of urinary tract and wound infections.4 % of them had both wound and urinary tract infections and 4% had only wound infection without significant difference between both groups. Diagnosis of urinary tract infection was by dysurea, complete urine analysis and urine culture and sensitivity tests. Diagnosis of wound infection was by swab culture and sensitivity tests. On the basis of this study we found that the usage of prophylactic antibiotics before skin incision and its usage at cord clamping are equally effective in preventing postoperative infective complications.