Antibiotic Prophylaxis in Ragged Placental Membranes
Antibiotic Prophylaxis in Ragged Placental Membranes
In some centres, women are routinely given a course of antibiotics postnatally if ragged
 placental membranes were present at delivery. The investigators examined the necessity such
 an intervention.
Postpartum endometritis resulting in sepsis remain one of the leading cause of maternal
 mortality in developing countries. Ragged placental membrane is a risk factor for
 endometritis and is not infrequently encountered. Several hospitals in Malaysia, largely
 those geographically-removed currently practice administering prophylactic antibiotics for
 women with ragged placental membranes. The aim is to reduce the risk of postpartum
 endometritis in a subgroup of women who may present in dire straits. The investigators sought
 to examine the necessity of such protocols.
Inclusion Criteria:

 All women who delivered vaginally beyond 24+0 weeks of gestation and were found to have
 ragged or retained placental membranes immediately after the third stage of labour were
 invited to participate in the study.

 Exclusion Criteria:

 1. Fever, within 5 days preceding delivery (Axillary temperature > 37.5oC on 2 or more
 occasions at least 1 hour apart or temperature > 38oC on one occasion). This also
 includes intrapartum fever.

 2. Required oral or intravenous antibiotics for any other obstetric-related (ex. third or
 fourth degree tears, preterm prelabour rupture of membranes) or non- obstetric related
 (ex. pneumonia, acute pyelonephritis) reasons

 3. Prolonged rupture of membrane (>18 hours)

 4. Retroviral disease, on long term oral or parenteral steroid or receiving other forms
 of immunosuppressants, including chemotherapy within the last one year.

 5. Vaginal delivery for an intrauterine death

 6. Penicillin allergy