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TOPLINE
Among women who had second-degree tears or episiotomy during vaginal delivery, those who had a long pushing stage of labor or deep tears had increased odds of wound complications of clinical relevance. Preventive antibiotics were linked to lower odds of such complications.
METHODOLOGY
- The REPAIR trial was a double‑blind randomized study that evaluated whether prophylactic antibiotics reduced wound complications after second-degree tears or episiotomy during vaginal births. Researchers conducted a secondary analysis to identify factors linked to those complications.
- During the original trial (March 2023-December 2023), women were randomly assigned to receive oral amoxicillin-clavulanic acid or placebo within 6 hours of delivery at a hospital in Denmark.
- A total of 433 women attended follow-up visit about 1 week postpartum. The final analysis included 412 women.
- Researchers defined a wound complication as clinically relevant when an infection or wound opening needed additional follow-up because of pain, the size of the wound, or signs of infection.
TAKEAWAY
- A total of 55 women who attended the follow-up consultation had a wound complication that was clinically relevant.
- The odds of wound complications were increased in women who had more than 60 minutes of active second stage of labor (adjusted odds ratio [aOR], 2.25) and in those who had deep tears reaching the perineal muscles (aOR, 2.11; P < .05 for both).
- Women whose suturing involved a doctor had increased odds of wound complications (aOR, 2.47; P = .01).
- Women who received amoxicillin-clavulanic acid had reduced odds of wound complications (aOR, 0.34; P = .001).
IN PRACTICE
"Although it remains unclear whether this reflects a direct effect or shared underlying risk factors, it highlights the importance of identifying women with wound complications and considering preventive strategies in future deliveries," the researchers wrote.
SOURCE
The study was led by Kathrine Perslev of Herlev University Hospital in Herlev, Denmark. It was published online on September 14 in the American Journal of Obstetrics and Gynecology.
LIMITATIONS
Assessment of complications relied on judgment of clinicians. Some high‑risk groups had fewer women and were underpowered. Few outcome events compared with many variables made the multivariable analysis exploratory.
DISCLOSURES
The study received funding from Herlev University Hospital, Copenhagen, Denmark. The first author reported receiving 6 months of salary support from Herlev and Gentofte Hospital, and the remaining expenses of the study were funded by the department. The authors reported having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
