Antibiotics During Intrauterine Balloon Tamponade Placement
Antibiotics During Intrauterine Balloon Tamponade Placement
The goal of this study is to identify whether antibiotics given at the time of placement of
 an intrauterine balloon tamponade (IBT) will result in reduction of the risk of endometritis.
 The investigators hypothesize that antibiotics given at the time of intrauterine balloon
 tamponade will reduce the likelihood of postpartum endometritis.
The investigators will perform a randomized, controlled trial of women who have had a
 postpartum hemorrhage and received an intrauterine balloon tamponade.

 Patients who are candidates for study enrollment will be identified on Labor & Delivery or in
 the Maternal-Fetal Care Unit. Patients who give consent will be randomized by random number
 generator to receive either antibiotics (Group A) or no antibiotics (Group B).

 If the patient is randomized to Group A, she will receive a 24-hour course of antibiotics.
 The primary antibiotic of choice will be cefazolin 1 gm iv q8 hours. If the patient has
 contraindications to the use of cefazolin including cefazolin allergy, hypersensitivity, or
 severe beta lactam allergy, then clindamycin 900 mg iv q8 hours will be used instead.

 If the patient is randomized to Group B, she will not receive antibiotics as part of the
 study, though if at any time her provider chooses to administer antibiotics either
 prophylactically or for treatment she will not prohibited in any way from this or any other
 treatment as appropriate.
Inclusion Criteria:

 -  Female

 -  Able to give consent

 -  Gestational age > 24 weeks

 -  Postpartum

 -  Placement of an IBT within the last 2 hours with plans for it to remain in situ for at
 least 2 hours

 -  Primary obstetrician amenable to proceeding with either method of management during
 the study period.

 Exclusion Criteria:

 -  Age < 18 years old

 -  IBT removed within 2 hours of placement

 -  Chorioamnionitis

 -  Insufficient documentation of demographics, delivery outcomes, or peripartum events
 including postpartum hemorrhage, infectious outcomes