WHO Recommendations for Prevention and Treatment of Maternal Peripartum Infections. September 2015

Key Messages

1. • Bacterial infections around the time of childbirth account for about one-tenth of maternal deaths    and contribute to severe morbidity and long-term disability for many affected women.
2. • Standard infection prevention and control measures are a cornerstone of peripartum infection prevention(e.g.,hand hygiene and use of clean equipment).
3. • WHO recommendations for prevention and treatment of maternal peripartum infections include both recommended and non-recommended interventions during labour, childbirth, and the postpartum period.
4. • Clinical monitoring, early detection, and prompt treatment of peripartum infection with an appropriate antibiotic regimen are essential for reducing death and morbidity in affected women.
5. • Recommendations for antibiotic prophylaxis/treatment for specific indications balance health benefits for the mother and newborn with safety concerns (e.g., adverse effects) and the public health imperative to control antibiotic resistance.

Good Clinical Practice:  
Observe Standard Infection Prevention and Control Measures and Judicious Use of Antibiotics to Control Antimicrobial Resistance 

1. • Identify and correct predisposing factors to infection (e.g., by providing nutritional advice and addressing nutritional deficiencies, anaemia, and other maternal medical conditions [e.g., diabetes]) during antenatal care. 
2. • Promote hand hygiene, use of clean products (e.g., blood products), use of clean equipment, and aseptic surgical practices (e.g., standard skin preparation techniques and proper use of antiseptic agents for surgical site preparation). 
3. • Maintain clean hospital environment (e.g., clean water, appropriate waste disposal, and sanitation).
4. • Develop and implement local protocols on infection prevention and control practices in accordance with existing WHO guidance.
5. • Promote judicious use of antibiotics (administer only for recommended indications; use narrowest antibacterial spectrum and simplest effective dose; verify woman’s history of drug intolerance; monitor local bacteria and antibiotic susceptibility and resistance patterns).