Guideline

WHO recommendations for prevention and treatment of maternal peripartum infections

Year of Publication

2015

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

22 included recommendations

Routine perineal/pubic shaving prior to giving vaginal birth is not recommended

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

Digital vaginal examination at intervals of four hours is recommended for routine assessment of active first stage of labour in low-risk women

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Very low

Routine vaginal cleansing with chlorhexidine during labour for the purpose of preventing infectious morbidities is not recommended

Status

Maintained

Recommended against

Strong

Certainty of evidence

Moderate

Routine vaginal cleansing with chlorhexidine during labour in women with group B Streptococcus (GBS) colonization is not recommended for prevention of early neonatal GBS infection

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

Intrapartum antibiotic administration to women with group B Streptococcus (GBS) colonization is recommended for prevention of early neonatal GBS infection

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

Routine antibiotic prophylaxis during the second or third trimester for all women with the aim of reducing infectious morbidity is not recommended.

Status

Maintained

Recommended against

Strong

Certainty of evidence

Very low

Routine antibiotic administration is not recommended for women in preterm labour with intact amniotic membranes

Status

Maintained

Recommended against

Strong

Certainty of evidence

Moderate

Antibiotic administration is recommended for women with preterm prelabour rupture of membranes

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

Routine antibiotic administration is not recommended for women with prelabour rupture of membranes at (or near) term

Status

Maintained

Recommended against

Strong

Certainty of evidence

Low

Routine antibiotic administration is not recommended for women with meconium-stained amniotic fluid.

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Low

Routine antibiotic prophylaxis is recommended for women undergoing manual removal of the placenta

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Very low

Routine antibiotic prophylaxis is not recommended for women undergoing operative vaginal birth.

Status

Retired

Recommended against

Conditional

Certainty of evidence

Very low

Routine antibiotic prophylaxis is recommended for women with a third- or fourth-degree perineal tear

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Very low

Routine antibiotic prophylaxis is not recommended for women with episiotomy

Status

Maintained

Recommended against

Strong

Routine antibiotic prophylaxis is not recommended for women with uncomplicated vaginal birth.

Status

Maintained

Recommended against

Strong

Certainty of evidence

Very low

Vaginal cleansing with povidone-iodine immediately before caesarean section is recommended.

Status

Retired

Recommended in favor

Conditional

Certainty of evidence

Moderate

The choice of an antiseptic agent and its method of application for skin preparation prior to caesarean section should be based primarily on the clinician’s experience with that particular antiseptic agent and method of application, its cost and local availability

Status

Retired

Recommended in favor

Conditional

Certainty of evidence

Low

Routine antibiotic prophylaxis is recommended for women undergoing elective or emergency caesarean section

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

For caesarean section, prophylactic antibiotics should be given prior to skin incision, rather than intraoperatively after umbilical cord clamping

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

For antibiotic prophylaxis for caesarean section, a single dose of first-generation cephalosporin or penicillin should be used in preference to other classes of antibiotics.

Status

Retired

Recommended in favor

Conditional

Certainty of evidence

Very low

A simple regimen such as ampicillin and once-daily gentamicin is recommended as first-line antibiotics for the treatment of chorioamnionitis.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

A combination of clindamycin and gentamicin is recommended as first-line antibiotics for the treatment of postpartum endometritis

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low