For a scheduled elective cesarean section, current ACOG guidance recommends administering prophylactic antibiotics at which point?

• A 24 hours before surgery as a single oral dose
• B Only after clamping of the umbilical cord
• C Immediately after uterine closure, before skin closure
• D Within 60 minutes before skin incision ✓

Explanation

Current practice, endorsed by ACOG and supported by randomized trials and meta-analyses, is to give cefazolin within 60 minutes before skin incision rather than waiting until cord clamping. Earlier administration achieves adequate tissue levels at the time of incision and reduces postpartum endometritis and wound infection without harming the neonate. The older practice of dosing after cord clamping was abandoned because it offered lower maternal benefit, making option B the classic outdated distractor.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.