Although current guidelines for antibiotic prophylaxis recommend the administration of narrow-spectrum antibiotics ( cefazolin ) after clamping of the umbilical cord , the data suggest that antibiotic administration before surgical incision or the use of extended-spectrum regimens ( involving azithromycin or metronidazole ) after cord clamp may reduce postcesarean maternal infection by up to 50 % .
: The use of either cefazolin alone before surgical incision or an extended-spectrum regimen after cord clamp seems to be associated with a reduction in  postcesarean maternal infection .
Post‐cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study
Objectives . The aim of this study was to document the true incidence of post‐cesarean surgical site infections ( SSI ) , according to the definition of the US Centers for Disease Control and Prevention ( CDC ) , and to identify independent risk factors for infection . Design . Prospect i ve  population ‐based cohort study in Norway . Setting . Sykehuset Asker og Bærum HF , a secondary community hospital , associated with the University of Oslo ( UiO ) , Norway , accounting for 2,000 deliveries per year . Participants . All cesarean deliveries during a 12‐month period from September 2003 . Main outcome measures . Rate and risk factors for SSI . Results . The total rate of SSI was 8.9 % , with an observation period of 30 days post‐operatively , compared to 1.8 % registered at hospital discharge . The total response rate was 100 % . There was no significant difference in SSI rate in elective or emergency cesarean section ( CS ) , respectively . All SSI were superficial . We found 2 significant independent risk factors : operating time ≥38 min and body mass index ( BMI ) > 30 . Conclusion . The rate of SSI is underestimated if the observation time is limited to the hospital stay . Operating time exceeding 38 min substantially increases the risk of SSI . The finding of no significant difference in SSI rate between elective and emergency CS should lead to a different approach concerning the use of antibiotics : subgroup at risk ( operating time ≥38 min and BMI > 30 ) may benefit from antibiotics in relation to the operation , whether the CS is an emergency or elective operation
Although current guidelines for antibiotic prophylaxis recommend the administration of narrow-spectrum antibiotics ( cefazolin ) after clamping of the umbilical cord , the data suggest that antibiotic administration before surgical incision or the use of extended-spectrum regimens ( involving azithromycin or metronidazole ) after cord clamp may reduce postcesarean maternal infection by up to 50 % .
: The use of either cefazolin alone before surgical incision or an extended-spectrum regimen after cord clamp seems to be associated with a reduction in  postcesarean maternal infection .