Maternal postpartum management and duration of therapy

Following vaginal delivery, provided that there are no features of sepsis, stop antibiotic therapy for intra-amniotic infection. Further antibiotic therapy is not routinely required because the risk of postpartum endometritis is low.

Following caesarean delivery, provided that there are no features of sepsis, give one additional dose of each of the antibiotics started preoperatively, and then stop therapy. If metronidazole or clindamycin was not in the preoperative regimen, add:

Consider continuing intravenous antibiotics for up to 24 hours following caesarean delivery for patients at increased risk of postpartum endometritis (eg obese patients, patients with prolonged labour or ruptured membranes).

There is no evidence that oral antibiotic therapy is beneficial after the discontinuation of intravenous therapy.

If the patient develops fever (38°C or more) and endometritis is suspected, see Empirical therapy for postpartum endometritis.