الفهرس 
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Abstract
Cesarean delivery is a major obstetrical surgical procedure aiming to save the lives of mothers and fetuses. The incidence of cesarean deliveries, both repeat and primary, has risen dramatically over the last few decades. As a surgical procedure, cesarean delivery may be accompanied by a number of complications, infection being one of them. The risk for developing post CS infection has significantly decreased in the last three decades, mainly owing to improvements in hygiene conditions, antibiotic prophylaxis, sterile procedures, and other practices. Aim of this study: The aim of this study is to determine if Azithromycin plus standard cephalosporin reduce the risk of post cesarean infection (endometritis, wound or other infection) compared to standard cephalosporin alone among women undergoing unscheduled cesarean delivery. Patients and methods: This study was carried out as a clinical trial study. The present study included 230 women who were intended to have CS. They were subdivided into two groups: • Study group (group 1): includes 115 women that received Azithromycin plus standard cephalosporin. • Control group (group 2): includes 115 women that received standard cephalosporin alone. By analyzing and processing the data obtained from the history and evaluation, our study declared that: • There was significant reduction of re-admission during puerperium among group 1(who received azithromycin plus standard cephalosporin) in comparison to group 2(who received standard cephalosporin alone) (0% vs 6.5%, p=0.01). • All signs and symptoms of endometritis were significantly reduced among group 1 in comparison to group 2, including: puerperal Fever >38OC (4.3% versus 15.2%), uterine tenderness (3.2% versus 11.9%), abdominal pain (1.1% versus 14.1%), offensive vaginal discharge (2.1% versus 13%) and purulent drainage from uterus (2.1% versus 9.8%) • All signs and symptoms of wound infection were significantly reduced among group 1 in comparison to group 2, including; erythema around incision (2.1%versus 8.7), induration around incision (3.2 versus 12%) and purulent discharge from incision site (1.1% versus 9.8%) • Also, the need for further antibiotic during puerperium was significantly reduced among group 1 (3.2% versus 11.9%). • There was no significant difference between the 2 groups regarding neonatal outcomes.