Tahmina Begum Poly1, Forhat Mahal2, Nahid Elora3, Muntasir Alam Rahimi4, Md Fahmidur Rahman5, Mohammad Nurunnabi6
1. Assistant Professor, Department of Gynecology and Obstetrics, North East Medical College & Hospital, Sylhet.
2. Professor, Department of Gynecology and Obstetrics, North East Medical College & Hospital, Sylhet.
3. Profesor, Department of Gynecology and Obstetrics, North East Medical College & Hospital, Sylhet.
4. Registrar, Department of Gynecology and Obstetrics, North East Medical College & Hospital, Sylhet.
5. Associate Professor, Department of Forensic Medicine and Toxicology, North East Medical College, Sylhet.
6. Assistant Professor, Department of Community Medicine and Public Health, Sylhet Women’s Medical College, Sylhet, Bangladesh.
Background: Caesarean section is a common obstetric procedure associated with increased risk of postoperative infections. Antibiotic prophylaxis is used to reduce maternal morbidity, but the optimal timing of administration remains debated.
Objectives. To compare the maternal outcomes of single-dose ceftriaxone administered preoperatively versus after umbilical cord clamping in women undergoing caesarean section.
Material and Methods: This comparative cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, North East Medical College Hospital, Sylhet, from January to June 2016. A total of 140 women with singleton pregnancies at 37 weeks gestation undergoing caesarean delivery were included. Patients were randomly assigned to two groups of 70 each: Group A received ceftriaxone before skin incision, and Group B received it after umbilical cord clamping.
Results: The groups were comparable in age (mean 25.40 ± 4.38 vs. 24.71 ± 3.94 years, p = 0.332 ), gestational age (38.60 ± 1.01 vs. 38.66 ± 1.09 weeks, p = (0.748), and gravidity (primigravida 42.9% vs 55.7%, p = 0.128), Antenatal care differed significantly, with more patients in Group A receiving regular care (70.0% vs. 45.7%, p = 0.004 ). Maternal infection morbidity, including wound infection (4.3% vs. 5.7%, p = 1), urinary tract infection (7.1% vs. 8.6%, p = 0.753), and febrile morbidity (7.1% vs. 10.0%, p = 0.546), did not differ significantly between the groups.
Conclusion: Preoperative and peroperative single-dose ceftriaxone provided similar maternal infection outcomes, with higher antenatal care in the preoperative group. Ceftriaxone, given before incision or after cord clamping, effectively reduces post-caesarean infections.
Keywords: Caesarean section, ceftriaxone, antibiotic prophylaxis, maternal infection, antenatal care. postoperative morbidity.