Intervention Review

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth

  1. Chompilas Chongsomchai1,*,
  2. Pisake Lumbiganon1,
  3. Malinee Laopaiboon2

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 21 MAR 2011

DOI: 10.1002/14651858.CD004904.pub2

Database Title

Additional Information

How to Cite

Chongsomchai C, Lumbiganon P, Laopaiboon M. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD004904. DOI: 10.1002/14651858.CD004904.pub2.

Author Information

  1. 1

    Khon Kaen University, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen, Thailand

  2. 2

    Khon Kaen University, Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen, Thailand

*Chompilas Chongsomchai, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Mittraphab Road, Khon Kaen, 40002, Thailand. cchomp@kku.ac.th.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 8 JUL 2009

SEARCH

ARTICLE TOOLS

View Full Article (HTML) Summary (54K)Standard (120K)Full (123K)
 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Retained placenta is a potentially life-threatening condition because of its association with postpartum haemorrhage. Manual removal of placenta increases the likelihood of bacterial contamination in the uterine cavity.

Objectives

To compare the effectiveness and side-effects of routine antibiotic use for manual removal of placenta in vaginal birth in women who received antibiotic prophylaxis and those who did not and to identify the appropriate regimen of antibiotic prophylaxis for this procedure.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (22 March 2011).

Selection criteria

All randomized controlled trials comparing antibiotic prophylaxis and placebo or non antibiotic use to prevent endometritis after manual removal of placenta in vaginal birth.

Data collection and analysis

If eligible trials were to be identified, trial quality would be assessed and data would be extracted, unblinded by two review authors independently.

Main results

No studies that met the inclusion criteria were identified.

Authors' conclusions

There are no randomized controlled trials to evaluate the effectiveness of antibiotic prophylaxis to prevent endometritis after manual removal of placenta in vaginal birth.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Prophylactic antibiotics for manual removal of retained placenta in vaginal birth

No trials to say if women with retained placenta after giving birth would benefit from routine antibiotics prior to manual removal of placenta.

Following the birth of her baby, a mother normally delivers the placenta with further pushing and support from her caregivers. Sometimes the placenta gets stuck on the wall of the womb (retained placenta) and does not deliver. These women usually require manual removal of the placenta under anaesthesia (either a general or regional). Infection and bleeding are the important complications of manual removal. The review found no trials to determine whether antibiotics given routinely (prophylactically) to all women with retained placenta reduced the incidence of problems. Future trials need to address the risk of contributing to drug resistant bacterial strains.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

在自然產時，針對人工移除滯留性胎盤(retained placenta)時所使用的預防性抗生素

滯留性胎盤是一種會對生命產生潛在性威脅的狀況，因為它會伴隨著產後出血。以人工方式將胎盤移除會增加細菌性汙染子宮的可能性。

目標

針對自然產而言，以人工方式將胎盤移除時，評估固定使用預防性抗生素的效用與副作用，與沒有接受抗生素的婦女來做比較，並確認預防性抗生素的合適療法。

搜尋策略

我們搜尋了the Cochrane Pregnancy and Childbirth Group Trials Register(2005年11月30日)、CENTRAL (The Cochrane Library，Issu ，2005年)、MEDLINE(從1966年到2005年一月)、EMBASE(從1980年到2005年一月)、CINAHL(從1982年到2005年一月)，以及LILACS(從1982年到2005年一月)。

選擇標準

在人工移除陰道產中的胎盤之後，就預防子宮內膜炎而言，所有隨機的對照試驗將使用預防性抗生素與安慰劑或不使用抗生素進行了比較。

資料收集與分析

2位審稿作者在未使用盲法的條件下獨立確認合格的試驗，評估試驗的品質，並擷取出資料。

主要結論

並沒有確認到有任何符合結論標準的研究。

作者結論

在人工移除陰道產中的胎盤之後，並沒有隨機的對照試驗，可以評估預防性抗生素對於預防子宮內膜炎的功效。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

並沒有試驗可以宣稱，在生產後帶有滯留性胎盤的婦女，是否會因為在人工移除胎盤之前固定地使用抗生素而得到助益。在寶寶出生之後，正常的情況下，醫療照護人員經由推動並給予協助，就可將胎盤生出來。有時候，胎盤會緊貼在子宮壁上(滯留性胎盤)，而且沒有辦法被生出來。通常這些婦女會需要在麻醉的情況下(無論是全身或局部)，經人工方式將胎盤移除。人工移除的過程中，感染與出血是重要的併發症。本篇回顧發現，固定地(預防性地)對所有帶有滯留性胎盤的婦女給予抗生素，並沒有試驗可以證實這樣是否可以降低問題的發生率。未來的試驗必須要強調是否會帶來對藥物產生抗藥性之菌種的風險。

View Full Article (HTML) Summary (54K)Standard (120K)Full (123K)