Infection inside the uterus
Endometritis, and why the prevention steps earlier mattered.
Infection of the uterine lining causes fever, foul-smelling discharge, and abdominal tenderness, usually in the first week. It requires intravenous antibiotics and often readmission.
The steps that lower this risk are the ones covered in the operation stage: antibiotics before the skin incision (uterine infection relative risk 0.54), azithromycin added for a cesarean in labor (infection 6.1% versus 12.0%), and vaginal cleansing before surgery (uterine infection 3.1% versus 7.1%).
Where this comes from:
301. Mackeen AD, Packard RE, Ota E, Berghella V, Baxter JK. Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery. Cochrane Database Syst Rev. 2014;(12):CD009516.
302. Tita ATN, Szychowski JM, Boggess K, et al. Adjunctive azithromycin prophylaxis for cesarean delivery. N Engl J Med. 2016;375(13):1231-1241.
304. Haas DM, Morgan S, Contreras K, Kimball S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev. 2020;(4):CD007892.
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