Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth

Most women are able to give birth without serious damage to their perineum. However, severe perineal trauma, which affects the muscle or tissue in the back passage, occurs in 1% to 8% of women giving birth and is common when forceps are used. There is an increased chance of infection when this happens, and antibiotics are often prescribed. The review of routine antibiotics for women with severe perineal tears identified one trial, involving 147 participants. This trial was conducted to explore the benefit of routine prophylactic antibiotics for women with severe perineal tears. The result showed fewer perineal wound complications when prescribing prophylactic antibiotic. However, the results are based on one small trial and there was a high loss to follow-up. More research is needed.