Southampton researchers have shown thousands of women could be spared pain and life-threatening infections if given antibiotics soon after every assisted birth.
As part of the UK-wide ANODE trial, Southampton’s reproductive health research team, has found a single dose of antibiotics after assisted childbirth could almost halve the number of infections women go on to develop.
Scaled up, this could help avoid 7,000 pregnancy-related infections across the UK every year, including issues linked to burst stitches and, in rare cases, life-threatening sepsis.
The findings are set to change standard practice in the UK, informing new advice that will be published by the UK’s Royal College of Obstetricians and Gynaecologists later this year.
An assisted birth is when forceps or a ventouse suction cup is used to help deliver a baby and accounts for one in eight UK births. This can increase the risk of infection by introducing bacteria into the genital tract, and these labours tend to be longer, with more vaginal examinations, tears and surgical cuts.
Involving over 3,400 women from 27 birthing units across the UK, including the Princess Anne Hospital in Southampton, this trial showed a single dose of antibiotics given within six hours after birth almost halved the number of infections.
“It is currently standard practice to give a single dose of antibiotics to women who give birth by caesarean section, or c-section, however these results suggest this should be extended to protect women against infections from assisted births,” explained Fiona Walbridge, research midwife and joint midwife lead for the Southampton-arm of the study.
“Whilst it might be expected that this approach would increase antibiotic use, the trial actually showed that overall antibiotic use fell.
“By catching infections before they took hold, every 100 doses of single-dose antibiotics prevented the need for doctors to prescribe 168 doses.”
Changing standard practice
Women who took part were either given an injection of an antibiotic (amoxicillin and clavulanic acid) or a saline placebo following the birth. In total, one third of the babies were born with ventouse and two thirds with forceps.
In the placebo group, 19% of women picked up an infection soon after childbirth, compared with 11% in the antibiotic group. More serious cases of sepsis, confirmed by a positive blood test, reached 1.5% in the placebo group, but only 0.6% in the antibiotic group, according to a report in the Lancet.
“Overall, women who were given the single dose of antibiotics were less likely to require treatment for perineal pain or burst stitches than those who had the placebo, and had fewer outpatient appointments and home visits after the birth.
“If this becomes standard practice across the UK, it could also lead to great savings for the NHS, through the use of fewer antibiotics and less hospital visits,” said Nicki Martin, senior research midwife and joint midwife lead for the Southampton-arm of the study.
Posted on Wednesday 18 September 2019