Antibiotic prophylaxis should be considered prior to vaginal delivery in certain women.


Heart conditions associated with a high risk of endocarditis:

(1) prosthetic cardiac valve

(2) prosthetic material used to repair a cardiac valve

(3) unrepaired cyanotic congenital heart disease

(4) palliated cyanotic congenital heart disease, including surgically reconstructed palliative conduits and shunts



• A history of infective endocarditis is not listed but would seem to be a significant risk factor.


Timing of first antibiotic dose: at the time of membrane rupture


Additional doses may be needed if there is a period of time between membrane rupture and vaginal delivery.


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