The ASPIRe Trial: Antibiotics for Severe Perineal Laceration to Prevent Infection following Repair

Many women experience severe lacerations during childbirth which put them at risk for infection and improper healing. This study aims to assess whether the use of oral antibiotics following vaginal delivery in women with severe tears is beneficial in protecting against wound infection and breakdown. We plan to randomize and then follow 274 women who have suffered a severe vaginal laceration. Women will all receive standard IV antibiotics at the time of repair and then be randomize to either receive 5 days of placebo medications or oral antibiotics. All women will have immediate, intensive follow-up with a urogynecologist at our well-established PEAPOD peripartum clinic at 1, 2, and 4 weeks postpartum to monitor wound healing and infection. At these visits, we also will assess women’s perception of their well-being and experience of postpartum pain associated with these lacerations. All participants will be invited to remain in the study for long-term follow-up. Our goal is to establish whether a five-day course of oral antibiotics should be a standard part of clinical care for severe postpartum lacerations.