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The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery.

Publication ,  Conference
Dotters-Katz, SK; Smid, MC; Grace, MR; Gunatilake, RP; Sykes, C; Blake, K; Boggess, KA; Patil, AS; Manuck, T
Published in: Am J Perinatol
June 2019

OBJECTIVE: To quantify the effects of operative blood loss during cesarean on tissue and plasma cefazolin concentrations. STUDY DESIGN: This was a prospective observational study of singleton pregnancies undergoing scheduled cesarean between 34 and 40 weeks. Cefazolin administered prior to skin incision. Maternal plasma samples were obtained (Time 1[T1]: immediately, T2: 20 minutes, T3: 40 minutes, and T4: 60 minutes after cefazolin infusion). Subcutaneous adipose tissue sampled before and after fascia. Primary outcome was subcutaneous adipose cefazolin level after fascial closure. Formal quantitative blood loss (QBL) performed. Women with higher QBL, those at/above 75% of QBL in this population, were compared with those with lower QBL (QBL below 75%). Data analyzed using bivariable statistics. RESULTS: Ninety-two women were screened, 32 were eligible, and 20 enrolled. Median QBL was 630 mL (interquartile range [IQR]: 473-818) and 1,160 mL (IQR: 1,000-1,560) in the low and high QBL groups, respectively. Demographics and operative characteristics were similar. Median adipose cefazolin level after fascial closure did not differ between the groups (3.5 vs. 3.9 μg/g, p = 0.75). No differences in maternal plasma cefazolin concentrations between the groups at any time point or in pharmacokinetic parameters were seen. CONCLUSION: Intraoperative maternal plasma concentrations and adipose levels of cefazolin are similar between women with high and low blood loss at the time of cesarean delivery.

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Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

June 2019

Volume

36

Issue

7

Start / End Page

688 / 694

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Prospective Studies
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Cesarean Section
  • Cefazolin
  • Blood Loss, Surgical
  • Antibiotic Prophylaxis
  • Anti-Bacterial Agents
 

Citation

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Dotters-Katz, S. K., Smid, M. C., Grace, M. R., Gunatilake, R. P., Sykes, C., Blake, K., … Manuck, T. (2019). The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery. In Am J Perinatol (Vol. 36, pp. 688–694). United States. https://doi.org/10.1055/s-0038-1673654
Dotters-Katz, Sarah K., Marcela C. Smid, Matthew R. Grace, Ravindu P. Gunatilake, Craig Sykes, Kimberly Blake, Kim A. Boggess, Avinash S. Patil, and Tracy Manuck. “The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery.” In Am J Perinatol, 36:688–94, 2019. https://doi.org/10.1055/s-0038-1673654.
Dotters-Katz SK, Smid MC, Grace MR, Gunatilake RP, Sykes C, Blake K, et al. The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery. In: Am J Perinatol. 2019. p. 688–94.
Dotters-Katz, Sarah K., et al. “The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery.Am J Perinatol, vol. 36, no. 7, 2019, pp. 688–94. Pubmed, doi:10.1055/s-0038-1673654.
Dotters-Katz SK, Smid MC, Grace MR, Gunatilake RP, Sykes C, Blake K, Boggess KA, Patil AS, Manuck T. The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery. Am J Perinatol. 2019. p. 688–694.
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

June 2019

Volume

36

Issue

7

Start / End Page

688 / 694

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Prospective Studies
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Cesarean Section
  • Cefazolin
  • Blood Loss, Surgical
  • Antibiotic Prophylaxis
  • Anti-Bacterial Agents