The effect of prophylactic antibiotic treatment for manual removal of the placenta on frequency of postpartum endometritis

Objective: To determine whether prophylactic antibiotics reduce the frequency of postpartum endometritis after manual removal of the placenta. Methods: A retrospective cohort study was conducted using data for all women who underwent manual removal of the placenta after vaginal delivery at a tertiary medical center in Jerusalem, Israel, between January 1, 2010, and December 31, 2015. The study group comprised women who had not received prophylactic antibiotic treatment, whereas the control group comprised women who had received prophylactic antibiotic treatment. The primary outcome measure was the frequency of postpartum endometritis. Results: Of the 407 women included in the analysis, 7 (1.7%) developed postpartum endometritis. Six of the women with postpartum endometritis had received prophylactic treatment with antibiotics, whereas one woman had not (odds ratio 0.555, 95% confidence interval 0.065–4.630). Conclusion: Prophylactic antibiotics before manual removal of the placenta did not decrease the odds of postpartum endometritis.