Antibiotics after second-degree tears cut the odds of wound complications by about two-thirds

The edition in brief

Five items for obstetricians and gynaecologists. In 433 Danish women with second-degree tears or episiotomy from the REPAIR trial, 12.7% had a clinically relevant wound complication; prophylactic amoxicillin-clavulanate was associated with lower odds (aOR 0.34, 0.18 to 0.65), while a prolonged active second stage (aOR 2.25) and a deep tear (aOR 2.11) raised them. In the placebo arms of two NICHD trials, 88.7% of women with subclinical hypothyroidism and 61.4% with hypothyroxinaemia had a normal thyroid test later in pregnancy, and only 2.0 to 2.5% became overtly hypothyroid, a caution against reflex early treatment. A meta-analysis of 156 observational studies associated cervicovaginal Ureaplasma parvum with preterm birth (OR 1.63) and Mycoplasma hominis with preterm birth (aOR 1.75) and low birthweight, but the authors state this does not support routine screening or treatment. A prospective study of 14,114 pregnant women found 1.7% were HPA-1b/1b; 2 of 19 higher-risk women followed up alloimmunised by 10 weeks post partum. The pearl covers what to check at the perineal review for women at higher risk of breakdown.