This is not the most recent version of the article. View current version (7 OCT 2014)

Intervention Review

Antibiotic prophylaxis for fourth-degree perineal tear during vaginal birth

  1. Pranom Buppasiri1,*,
  2. Pisake Lumbiganon1,
  3. Jadsada Thinkhamrop1,
  4. Bandit Thinkhamrop2

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 19 OCT 2005

Assessed as up-to-date: 29 JUL 2005

DOI: 10.1002/14651858.CD005125.pub2


How to Cite

Buppasiri P, Lumbiganon P, Thinkhamrop J, Thinkhamrop B. Antibiotic prophylaxis for fourth-degree perineal tear during vaginal birth. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD005125. DOI: 10.1002/14651858.CD005125.pub2.

Author Information

  1. 1

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

  2. 2

    Khon Kaen University, Department of Demography and Biostatistics, Khon Kaen, Thailand

*Pranom Buppasiri, Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Faculty of Medicine, Khon Kaen, Khon Kaen, 40002, Thailand. bprano@kku.ac.th.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 OCT 2005

SEARCH

This is not the most recent version of the article. View current version (07 OCT 2014)

 

Abstract

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

Background

One to eight per cent of women suffer third-degree perineal tears (anal sphincter injury) and fourth-degree perineal tear (rectal mucosa injury) during vaginal birth, and these tears are more common after forceps delivery (28%) and midline episiotomies. Fourth-degree tears can become contaminated with bacteria from the rectum and this significantly increases in the chance of perineal wound infection. Prophylactic antibiotics might have a role in preventing this infection.

Objectives

To assess the effectiveness of antibiotic prophylaxis for reducing maternal morbidity and side-effects in fourth-degree perineal tear during vaginal birth.

Search strategy

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 July 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 2), MEDLINE (1966 to 15 July 2005), and LILACS (1982 to 15 July 2005). We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 1 December 2009 and added the results to the awaiting classification section.

Selection criteria

Randomised controlled trials which reported data comparing outcomes of prophylactic antibiotics versus placebo or no antibiotics in fourth-degree perineal tear during vaginal birth.

Data collection and analysis

No trials were found that met the selection criteria.

Main results

No randomised controlled trials were identified.

Authors' conclusions

There are insufficient data to support a policy of routine prophylactic antibiotics in fourth-degree perineal tear during vaginal birth. A well-designed randomised controlled trial is needed.

[Note: The two citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

 

Plain language summary

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

Antibiotic prophylaxis for fourth-degree perineal tear during vaginal birth

No trials looking at routine antibiotics for women with severe perineal tears at birth.

Most women are able to give birth without serious damage to their perineum. However, severe perineal trauma, which affects the muscle or tissue in the back passage, occurs in 1% to 8% of women giving birth and is common when forceps are used. There is an increased chance of infection when this happens, and antibiotics are often prescribed. The review of routine antibiotics for women with severe perineal tears found no trials. Hence, there is no strong evidence to support the effectiveness of prophylactic antibiotics in these situations. More research is needed.