Cesarean delivery (CD) are the  most  commonly performed  surgical  procedure  worldwide . According to Cochrane Database Systematic Review in 2002 endometritis is the most frequent post Cesarean complication classically reported in upto 50% of patients . Cesarean  delivery  is associated  with  a  significantly  higher  post-operative  infections such as  surgical  site infection,  urinary  tract  infection (SSI,UTI) and uterine infection   rate  when compared to following  vaginal  birth and  instrumental deliveries .In the present era due to increasing number of Cesarean deliveries  infections are  likely to become a significant health  and  economic  burden .

       Post–Cesarean  delivery  endometritis  is   generally  believed  to  have  a  polymicrobial etiology  resulting from  ascension  of  bacteria  from  the  lower  to  the  upper  genital  tract. There  is overwhelming  evidence  that  antibiotic  prophylaxis  for  cesearean  delivery   is  effective in  preventive  maternal  infectious  morbidity.

        Cefazolin was used as prophylaxis after cord clamping based on evidence of National institute for Health and Care Excellence (NICE) guidelines 2011 .Based on a study done in CMCH and The Society of Obstetricians and Gynaecologists of Canada( SOGC) 2010, this was changed to using Cefazolin 15-30 minutes prior to skin incision in order to decrease the surgical site infection.

        The  association between  ureaplasm  urealyticum  colonization  of  the  chorioamnion  at  Cesarean  delivery (CD) and  an  increased  risk  of  post – Cesarean  delivery  endometritis   occurred  despite  the routine  use  of  intraoperative  prophylactic  antibiotics .  When  these  organisms  are detected , there  is  a  3-8  fold  increased  risk of  endometritis  or  wound  infection  post Cesarean  delivery.

          Broad-spectrum  antibiotics when used, were  associated  with  a  statistically  significant reduction  in  endometritis  and  wound  infection  compared  to  narrow-spectrum antibiotics . Length  of  hospital  stay  was  significantly  shorter  when  broad-spectrum antibiotics  were  used.  The  leading  option  as  a  second-line  broad-spectrum  antibiotic for  Cesarean  delivery  appears  to  be  Azithromycin,  which  has  a  longer  half-life  (68 hours) , higher  tissue  concentrations  and  lower  transplacental  passage  than  several other  antibiotics  commonly  used  for  this  indication.  In  addition,  azithromycin  is  active  against  both  aerobes  and  anaerobes,  as  well  as Ureaplasmas,  resulting  in significantly  less  endometritis  and  wound  infection  than  in  studies  in  which  other antibiotics  were  used.

     In the present study we  aim  to  compare  the following outcome measures in the mother such as surgical site infection , endometritis , UTI  &  serious infections  . The  duration  of  hospital stay  in  mothers  will  be   looked  at.