Who Recommendation On Routine Antibiotic Prophylaxis For Women Undergoing Operative Vaginal Birth

“Operative vaginal birth” is the term used to describe delivery of the fetal head assisted by either vacuum extractor or forceps. The Guideline Development Group noted that the available evidence, from highincome countries, strongly supports the use of a single dose of intravenous amoxicillin (1 g) and clavulanic acid (200 mg) administered as soon as possible after birth and no more than 6 hours after birth. The effects of other antibiotics and routes of administration for this indication are unknown. The Guideline Development Group recognized that intravenous amoxicillin and clavulanic acid may not be readily available or feasible to use in resource-limited settings and suggested that where this combination is not available, providers should consider the use of an appropriate class of antibiotics with similar spectrum of activity, based on local antimicrobial resistance patterns, safety profile (including allergies), the clinician’s experience with that class of antibiotics, availability and cost. The risk of postpartum infections and side-effects of antibiotics should be discussed with all women undergoing operative vaginal birth at the earliest time possible before or after birth. This recommendation was based on agreement by the Guideline Development Group that the improved health outcomes for women were clinically significant and outweighed the potential effects on emerging antimicrobial resistance.

The Guideline Development Group noted that the available evidence on the effectiveness of antibiotics for caesarean section was largely derived from trials that tested first- or second-generation cephalosporins or penicillins in the 1980s and 1990s. Based on consensus, the Guideline Development Group favoured these classes of antibiotics over other classes of antibiotics, as they have a broad spectrum of activities and are widely available in all settings. While the Guideline Development Group members acknowledged the lack of clear difference between first- and second-generation cephalosporins, they noted that the evidence suggests that third-generation cephalosporins may be less effective than penicillins for this indication, and therefore suggests that this class of antibiotics should be avoided. The Guideline Development Group noted that first-generation cephalosporins are the preferred antibiotic class for prophylaxis in general surgery, as part of efforts to contain antimicrobial resistance. In acknowledgement of the lack of evidence on the comparative effectiveness of different classes of antibiotics, the Guideline Development Group concluded that when the recommended antibiotic classes are not available, other classes of antibiotics may also be used. The Guideline Development Group noted that the choice of an antibiotic class should be informed by local antimicrobial resistance guidance, local bacteriologic patterns of post-caesarean infectious morbidity, safety profile, the clinician’s experience with that particular class of antibiotics, availability and cost.

The goal of the present guideline is to consolidate guidance for effective interventions that are needed to reduce the global burden of maternal infections and its complications around the time of childbirth. This forms part of WHO's efforts towards improving the quality of care for leading causes of maternal death especially those clustered around the time of childbirth in the post-MDG era. Specifically it presents evidence-based recommendations on interventions for preventing and treating genital tract infections during labour childbirth or puerperium with the aim of improving outcomes for both mothers and newborns. The primary audience for this guideline is health professionals who are responsible for developing national and local health protocols and policies as well as managers of maternal and child health programmes and policy-makers in all settings. The guideline will also be useful to those directly providing care to pregnant women including obstetricians midwives nurses and general practitioners. The information in this guideline will be useful for developing job aids and tools for both pre- and inservice training of health workers to enhance their delivery of care to prevent and treat maternal peripartum infections.

Provides effective diagnosis and management of infectious diseases in pregnant women in a single comprehensive available resource for busy clinicians.

NEW! Case studies for the Next Generation NCLEX®. NEW! Content on COVID-19 includes current recommendations from professional organizations related to vaccines and the care of pregnant women and newborns. UPDATED! Increased coverage of the needs of nontraditional families. UPDATED! Coverage of legislative changes that affect health care delivery in the United States. UPDATED! Current recommendations and practice changes from professional organizations, such as the American College of Obstetricians and Gynecologists (ACOG), the Association for Women’s Health, Obstetric and Neonatal Nurses (AWHONN), and the American Academy of Pediatrics (AAP). UPDATED! Enhanced content on client- and family-centered care focuses on diversity and cultural assessment. UPDATED! Added emphasis on racial disparities in relation to women’s health and childbearing. UPDATED! Cutting-edge content on treatments for breast cancer.

At a UN General Assembly Special Session in 1999, governments recognised unsafe abortion as a major public health concern, and pledged their commitment to reduce the need for abortion through expanded and improved family planning services, as well as ensure abortion services should be safe and accessible. This technical and policy guidance provides a comprehensive overview of the many actions that can be taken in health systems to ensure that women have access to good quality abortion services as allowed by law.

This book is meant to bridge the gap between small handbooks that do not contain enough material to understand why you are doing certain things and large textbooks that lack the practical information you need for how to do specific procedures, write notes, orders, and dictations. After reading it, you will be prepared to care for an obstetric patient from the moment they arrive in triage until the time they are discharged. You will understand not only how to perform both simple and complicated procedures, but also why they are necessary, and you will have the answers to the most common pimp questions that are asked of students and residents. The most up-to-date literature and evidence-based recommendations have been used to create simple treatment algorithms for the most common issues you will face, and numerous illustrations are included for clarity as well. Because of its focus, this book is also valuable resource for staff physicians who need an updated text on current obstetric care as well as for those who regularly interact with and teach medical students and residents.