Among pregnant women in labour (P), does routine perineal/pubic shaving prior to giving birth (I), compared with no perineal/pubic shaving (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (episiotomy, perineal or vaginal) (C)
Local discomfort (perineal irritation/allergy) (C) |
Maternal satisfaction with care (I)
Cost of care (I)
Neonatal infection (I) |
- 2.
Among pregnant women undergoing labour monitoring (P), does routine vaginal examination at intervals of four hours (I), compared with shorter intervals (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Wound infection (episiotomy, perineal or vaginal) (C)
Neonatal infection (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C)
Perinatal mortality (C) |
Maternal death (I)
Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (I)
Maternal satisfaction (I)
Maternal hospital stay (I)
Cost of care (I) |
- 3.
Among pregnant women in labour (P), does routine vaginal cleansing with an antiseptic agent (I), compared with no vaginal cleansing with an antiseptic agent (C), prevent infectious morbidities and improve outcomes following vaginal birth (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Side-effects (vaginal irritation/allergic reaction) (C)
Wound infection (episiotomy, perineal or vaginal) (C)
Perinatal mortality (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C)
Neonatal infection (C) |
Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (I)
Maternal death (I)
Cost of care (I) |
- 4.
Among pregnant women with vaginal, rectal or urethral colonization with group B Streptococcus (P), does routine vaginal cleansing with an antiseptic agent during labour (I), compared with no vaginal cleansing with an antiseptic agent (C), prevent neonatal infectious morbidities and improve neonatal outcomes (O)?
| Local discomfort (vaginal irritation/allergic reaction) (C)
Neonatal death (C)
Neonatal infection (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (I)
Cost of care (I)
Maternal satisfaction (I)
Chorioamnionitis or maternal intrapartum infection (I)
Wound infection (episiotomy, perineal or vaginal) (I) |
- 5.
Among pregnant women with vaginal, rectal or urethral colonization with group B Streptococcus (P), does routine administration of antibiotics during labour (I), compared with no antibiotics (C), prevent neonatal infectious morbidities and improve neonatal outcomes (O)?
| Antimicrobial resistance (C)
Perinatal mortality (C)
Neonatal infection (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (I)
Maternal satisfaction (I)
Chorioamnionitis or maternal intrapartum infection (I)
Wound infection (episiotomy, perineal or vaginal) (I)
Side-effects of antibiotics (I)
Cost of care (I) |
- 6.
Among women in the second or third trimester of pregnancy (P), does routine antibiotic prophylaxis (I), compared with no antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (episiotomy, perineal or vaginal) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, maternal ICU admission) (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C)
Perinatal mortality (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C)
Neonatal infection (C) |
| Cost of care (I) |
- 7.
Among pregnant women in preterm labour with intact amniotic membranes (P), does routine antibiotic prophylaxis (I), compared with no routine antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis with/without salpingitis causing maternal febrile morbidity) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Maternal death (C)
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, or maternal ICU admission) (C)
Perinatal mortality (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C) |
- 8.
Among pregnant women with preterm prelabour rupture of membranes (P), does routine antibiotic prophylaxis (I), compared with no routine antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Maternal death (C)
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, or maternal ICU admission) (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C)
Perinatal mortality (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
- 9.
Among pregnant women with prelabour rupture of membranes at (or near) term (P), does routine antibiotic prophylaxis (I), compared with no routine antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Maternal death (C)
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, or maternal ICU admission) (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C)
Perinatal mortality (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
- 10.
Among pregnant women with meconium-stained amniotic fluid during labour (P), does routine administration of antibiotics (I), compared with no routine antibiotics (C), prevent infectious morbidities and improve outcomes (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Chorioamnionitis or maternal intrapartum infection (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Side-effects of antibiotics(C)
Antimicrobial resistance (C)
Neonatal mortality (C)
Neonatal infection (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
| Cost of care (I) |
- 11.
Among women undergoing manual removal of retained placenta following birth (P), does antibiotic prophylaxis (I), compared with no antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, or maternal ICU admission) (C)
Maternal death (I)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Side-effects of antibiotics (I)
Antimicrobial resistance (C) |
Wound infection (episiotomy, perineal, or vaginal) (I)
Cost of care (I) |
- 12.
Among women undergoing operative vaginal delivery (P), does routine antibiotic prophylaxis (I), compared with no prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (episiotomy, perineal, or vaginal) (C)
Antimicrobial resistance (C) |
Side-effects of antibiotics (I)
Cost of care (I)
Neonatal sepsis (I)
Neonatal mortality (I) |
- 13.
Among women with third-or fourth-degree perineal tear after birth (P), does routine antibiotic prophylaxis (I), compared with no antibiotic prophylaxis (C), prevent maternal infectious morbidities and improve outcomes (O)?
| Wound infection (perineal) (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Local discomfort (C)
Sexual dysfunction (C) |
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, or maternal ICU admission) (I)
Duration of hospital stay (I)
Side-effects of antibiotics (I)
Cost of care (I) |
- 14.
Among women who had an episiotomy for vaginal birth (P), does routine antibiotic prophylaxis (I), compared with no routine antibiotic prophylaxis (C), prevent maternal infectious morbidities and improve outcomes (O)?
| Wound infection (C)
Wound dehiscence (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C) |
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, maternal ICU admission) (I)
Discomfort/pain at episiotomy wound site (I)
Cost of care (I)
Maternal hospital stay (I)
Antimicrobial resistance (I) |
- 15.
Among pregnant women with uncomplicated vaginal birth (P), does antibiotic prophylaxis after birth (I), compared with no prophylaxis or placebo (C) prevent infectious morbidities and improve outcomes (O)?
| Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (C)
Urinary tract infection (C)
Maternal hospital stay (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C) |
| Cost of care (I) |
- 16.
Among pregnant women with indications for caesarean section (P), does vaginal cleansing with an antiseptic agent prior to caesarean delivery (I), compared with no vaginal cleansing with an antiseptic agent (C), prevent postoperative maternal infectious morbidities (O)?
| Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C) |
Wound infection (I)
Side-effects of antiseptics (vaginal irritation/allergy) (I)
Cost of care (I) |
- 17.
Among pregnant women undergoing caesarean delivery (P), is the use of a particular antiseptic agent for preoperative skin preparation (I), compared with other antiseptic agent(s) (C), more effective in preventing post-caesarean infectious morbidities (O)? Among pregnant women undergoing caesarean delivery (P), is the use of a particular method of antiseptic application for preoperative skin preparation (I), compared with other methods of antiseptic application (C), more effective in preventing postcaesarean infectious morbidities (O)?
| Wound infection (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Severe maternal infectious morbidity (septicaemia, septic shock, laparotomy or hysterectomy for infection, maternal ICU admission) (C) |
Maternal death (I)
Cost of care (I)
Allergy/irritation at operation site (I)
Maternal satisfaction (I)
Neonatal infection (I)
Severe neonatal morbidity (e.g. neonatal ICU admission) (I) |
- 18.0.
Among women undergoing caesarean section (P), does routine antibiotic prophylaxis (I), compared with no antibiotic prophylaxis (C), prevent infectious morbidities and improve outcomes (O)?
| Maternal death (C)
Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (C)
Antimicrobial resistance (C) |
Neonatal sepsis (I)
Neonatal mortality (I)
Side-effects of antibiotics (I)
Cost of care (I) |
- 18.1.
Among women receiving antibiotic prophylaxis for caesarean section (P), is preoperative administration of antibiotics (I), compared with intraoperative administration of antibiotics after umbilical cord clamping (C), more effective in preventing maternal and neonatal infectious morbidities (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (C)
Severe neonatal morbidity (e.g. neonatal ICU admission) (C) |
Maternal death (I)
Side-effects of antibiotics (I)
Cost of care (I)
Antimicrobial resistance (I)
Neonatal infection (I)
Neonatal mortality (I) |
- 18.2.
Among women receiving routine antibiotic prophylaxis for caesarean section (P), is the use of a particular class of antibiotics (I), compared with other classes of antibiotics (C), more effective in preventing postoperative infectious morbidities (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis with/without salpingitis causing maternal febrile morbidity) (C)
Wound infection (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C) |
Maternal death (I)
Cost of care (I)
Antimicrobial resistance (I)
Neonatal mortality (I)
Neonatal infection (I) |
- 19.
Among women receiving antibiotic treatment for intra-amniotic infection / chorioamnionitis (P), is the use of a particular antibiotic regimen (I), compared with other regimens (C), more effective in improving maternal and neonatal outcomes (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Puerperal sepsis (endometritis with/without myometritis and with/without salpingitis causing maternal febrile morbidity) (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C)
Neonatal mortality (C)
Neonatal infection (C) |
Maternal death (I)
Cost of care (I) |
- 20.
Among women receiving antibiotic treatment for postpartum endometritis (P), is the use of a particular antibiotic regimen (I), compared with other regimens (C), more effective in improving maternal outcomes (O)?
| Severe infectious morbidity (septicaemia, septic shock, laparotomy/hysterectomy for infection, maternal ICU admission) (C)
Duration of hospital stay (C)
Side-effects of antibiotics (C)
Antimicrobial resistance (C)
Long-term complications e.g. subfertility, uterine adhesions (C) |
Maternal death (I)
Cost of care (I) |