Manual Placenta Removal causes Increased Postpartum Prescriptions of Antibiotics

There is a lack of consensus regarding whether to prescribe prophylactic antibiotics in conjunction with manual placenta removal. The present study investigated the postpartum risk of a new prescription of antibiotic treatment after manual placenta removal.

It merged Obstetric data with that from the Anti-Infection Tool (Swedish antibiotic registry) and included all vaginal deliveries (n = 13877). The study analyzed the risk of a prescription of antibiotics 24 h to 7 days postpartum in the overall study population and in a cohort of women not having received any antibiotics 48 h before delivery until 24 h after delivery, referred to as “antibiotic-naïve.”

The study observed-

• Association between manual placenta removal and an increased risk of an antibiotic prescription. 
• Association between manual placenta removal with an increased risk of antibiotic prescription, in general, endometritis-specific antibiotics and intravenous antibiotics, in the antibiotic-naïve subgroup.

This study shows an association between manual placenta removal and an elevated risk of antibiotic treatment postpartum. In an antibiotic-nave population, prophylactic antibiotics may reduce the risk of infection; however, more prospective studies are needed.

Source: Janson A, Ignell C, Stuart, A. Manual Placenta Removal is Associated with Increased Postpartum Prescriptions of Antibiotics: a Retrospective Cohort Study of Data from the Anti-Infection Tool. J Obstet Gynecol India. 2023; 73:15–20. https://doi.org/10.1007/s13224-022-01696-x