Objective: To study the effects of elective cesarean section and antibiotics to the bacterial flora in the normal female genital tract.
Methods: Forty-five cases of elective cesarean section were randomly divided into 3 groups: no antibiotic was given (group A), one antibiotic was given for three days (group B), and only once antibiotic was used (group C). Bacterial cultures of vaginal swab and specimens aspirated from uterine cavity were performed in each case before and after operation to supervise the changes of bacterial flora in genital tract and postoperative infection.
Results: The positive rate of bacterial culture was 35.71% before operation but 64.29% after operation (P < 0.01). The numbers of aerobe and anaerobe were 3 and 10 strains, respectively, before operation, and 16 and 18 strains after operation. The counts of anaerobe were more than those of aerobe in group A either before or after operation in group A. The counts of aerobe, on the other hand, were more than those of anaerobe both in group B and C after operation. The rates of positive bacterial culture in uterine cavity after operation were similar among the three groups (P > 0.05). Interestingly the operative infection rates were 6.67% evenly.
Conclusions: Both cesarean section and antibiotics may disturb the bacterial flora in the normal female genital tract. The disturbance may increase the chance for flora imbalance and the postoperative infection. There was a great need for rational application of prophylactic antibiotics after cesarean section. Single-dose antibiotic during cesarean section should be advocated.