الفهرس 
Caesarean sectionOnly 14 pages are availabe for public view
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Abstract
Background: The rate of obesity among women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery.Obesity is associated with comorbidities, anatomical factors (ie, skin folds and increased tissue pressure), and bioactive adipose tissue that increase the risk of SSI. Aim of the Work: to compare between the efficacy of cephalexin plus metronidazole and cephalexin alone for prevention of SSI in obese women undergoing CS delivery. Patients and Methods: This interventional prospective randomized controlled clinical trial was conducted on 280 subjects according to inclusion and exclusion criteria divided randomly in 2 groups (A & B), from them 270 patients completed follow up. In group A patients were received 2gm cephalexin IV before skin incision then postoperatively they were received 1 gm cephalexin IV after 8 hrs. In group B patients were received 2gm cephalexin IV before skin incision plus 1gm metronidazole rectally at time of urinary catheter insertion then postoperatively they were receive 1gm cephalexin IV plus 1gm metronidazole rectally after 8hrs.Both groups were followed for the occurrence of SSI, endometritis, UTI, febrile morbidities, hospital stay and readmission and studied drugs side effects. Results: In the results of this study, there was a statistical difference in rates of post operative SSI (P>0.05). Wound infection was the most common postpartum complication in both groups, the percentage of wound infection was more frequent in group A (control group) than group B (study group), the difference was statistically significant between them. There was no significant difference between both groups concerning other maternal postpartum outcome. There was no significant difference between the women in both groups concerning hospital readmission, receiving therapeutic antibiotic. Concerning Hospital readmission: in group A, 2 patients was readmitted to manage wound infection (wound dehiscence) and in group B no one was readmitted at hospital. As regard etiology of therapeutic antibiotic, it was mainly to manage wound complications according C&S. Conclusion: involving obese women undergoing cesarean delivery after receiving prophylactic combined antibiotic (cephalexin plus metronidazole) prior to CS was more effective than single antibiotic administration (cephalexine alone) in reducing post-CS SSI in class I obesity.