In Ghana, infection has been identified as a major cause of birth-related mortality. Results of a 2-month observation of infection control practices among Ghanaian obstetric nurses and midwives indicated that most personnel did not practice basic rules of asepsis. Problems included frequent breaks in technique, inadequate sterilization and disinfection, and repeated exposure to large amounts of blood and vaginal secretions. Supplies were limited and, even when available, not always used appropriately. The situation in developing countries is different from that in the United States. Therefore, an observational needs assessment is essential to plan relevant and practical measures for change.

https://www.jognn.org/article/S0884-2175(15)33031-8/pdf

Obstetric Infection Control in a Developing Country

Objetivos: avaliar a eficiencia de varios esquemas de antibioterapia profilatica no parto na prevencao da infeccao puerperal. Metodos: segundo a via de parto (vaginal ou abdominal) e conforme a presenca ou nao de um ou mais fatores de risco para infeccao puerperal, as pacientes foram distribuidas entre os grupos de baixo, medio e alto risco para a infeccao puerperal. Foram incluidas 2.263 pacientes no periodo de marco de 1994 a junho de 1997. Resultados: a incidencia de infeccao puerperal variou entre os grupos. Foi de 3,1% no grupo de baixo risco, em que nenhum antibiotico foi administrado e de 8, 5% no grupo de alto risco, no qual todas as pacientes receberam cefalotina 1 g EV em tres doses, com intervalo de seis horas entre as doses. No grupo de medio risco a taxa de infeccao puerperal foi de 5,3 % entre as pacientes que receberam cefoxitina 1 g EV em tres doses; 5,0% entre as usuarias de cefalotina 1 g EV em tres doses; 4,0% quando se utilizou a cefoxitina em dose unica e 3,4% quando utilizou-se cefalotina em dose unica. Conclusoes: no grupo de baixo risco e desnecessaria a antibioticoterapia profilatica. A cefalosporina de 2ageracao (cefoxitina) teve eficacia semelhante a de 1ageracao (cefalotina) na prevencao a infeccao puerperal, independente da posologia utilizada. A cefalotina parece ser eficaz na prevencao da infeccao puerperal no grupo de alto risco.

/pdf/antibioticoterapia-profilatica-em-obstetricia-comparacao-4b6eihz1te.pdf

Antibioticoterapia profilática em obstetrícia: comparação entre esquemas

Infection in the obstetrics-gynecology patient remains an important source of concern. Advances in the identification of pathogenic organisms have led to improvements in the diagnosis of pelvic infections. Important considerations in the selection of antibiotics for established infections include prior hospitalization status, the size of the bacterial inoculum causing the infection, the etiologic organisms and, in the case of prophylaxis, the type of operative procedure. The antibiotic must also be cost effective.

Overview of therapeutic and prophylactic antibiotics in obstetrics and gynecology.

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Overview of therapeutic and prophylactic antibiotics in obstetrics and gynecology.