الفهرس 
CESAREAN SECTIONOnly 14 pages are availabe for public view
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Abstract
Objective: To investigate the efficacy of adding azithromycin to cephalosporin for the prophylaxis against wound infection, which is considered primary outcome, endometritis, respiratory tract infection and urinary tract infection being secondary outcomes in high-risk women planned for elective lower segment cesarean section.
Methods: This study was carried out at Ain Shams Maternity Hospital. 144 obese pregnant women with BMI 30-34.9 kg/m2 planned for elective lower segment cesarean section were distributed into two equal groups. Control group 72 women received single antibiotic chemotherapy 1st generation cephalosporin 2gm IV within 30 minut e s before skin incision and study group received combined antibiotic chemotherapy azithromycin 1 gm single oral dose 2 hours before cesarean delivery +cephalosporin within 30 mins before skin incision. Postoperatively any sign of maternal infection was notified.
Results: This present study showed that the difference was statistically insignificant between two groups according to demographic data (age and BMI) and hemoglobin level however in relation to random blood glucose levels in both groups the difference was statistically insignificant. Regarding primary and secondary outcomes which revealed that in relation to primary outcome 12 only out of 60 patients had complications among group 1 (Cefazolin) versus 4 cases only among group 2(Cefazolin +azithromycin) and the difference was statistically significant (X2=5.063, p=0.041), the first complication was superficial Incisional SSI which contributed about 8.3% among group 1(Cefazolin) versus 3% among group 2 (Cefazolin +azithromycin) and the difference was statistically significant (X2=3.069, p=0.048) ,the second complication was deep incisional SSI which contributed about 11.6% among group 1 (Cefazolin) versus 3.1% among group 2 (Cefazolin + Azithromycin) and the difference was statistically significant (P = 0.049 ),in directional to secondary outcome 10 out of 60 patients had complications among group 1 Cefazolin) versus3 cases only among group 2 (Cefazolin +azithromycin) having statistically significant difference (X2=5.143, p=0.039), postpartum endometritis which contributed about 13.3% among group 1(Cefazolin) versus 3.1% among group 2 (Cefazolin +azithromycin) and the difference was statistically significant (X2=3.069, p=0.048).
Conclusion: In the present study, it is found that there is a good overall agreement to the efficacy of adding azithromycin to cephalosporin for the prophylaxis against postoperative wound infection, endometritis, respiratory tract infection and urinary tract infection in high-risk women planned for elective lower segment cesarean section.