Infections in Cesarean Section Wound and Its Associated Risk Factors

Abstract

Objective: To evaluate the occurrence of post-caesarean wound infections and their contributing factors, thereby facilitating the development of effective preventive measures and interventions to improve maternal and neonatal outcomes.

Methodology: Descriptive Case Series study was conducted at obstetrics and gynaecology department of Nishtar Hospital, Multan from July 2021 to Dec 2021.  Women aged more than 17 years, who had undergone caesarean section procedure of either parity and gestational age were included. All patients in this study underwent either emergency or elective caesarean section procedures. Each patient was closely monitored for 30 days post-procedure, with regular examinations conducted to detect any signs of wound infection, including redness or purulent discharge. All pertinent details were documented using a pre-established data collection form. Data analysis was carried out using SPSS version 26.0, with post-stratification conducted to account for potential effect modifiers. The significance of observed differences was assessed using the chi-square test, considering a p-value of < 0.05 as statistically significant.

Results: The patients mean age was 29.33 years and a standard deviation of 2.72 years and the average gestational age was 37.13 +1.04 weeks. Overall, 9.1% of patients had wound infections following the caesarean section. Anemia and obesity were the most common factors, accounting for 5.8% of the total sample each. Diabetes mellitus and emergency lower segment caesarean section (LSCS) were each observed in 4 cases, making up 3.3% and 4.1% of the total, respectively. Prolonged rupture of membranes (PROM) and hypertension (HTN) were contributing factors in 1.7% of the sample for each factor. Although the rate of infection was statistically not significant according to age and gestational age (p >0.5). In terms of BMI, patients with a BMI greater than 25 had a significantly higher infection rate compared to those with a BMI less than 25, with 7 cases (5.8%) and 4 cases (3.3%) respectively (p=0.035).

Conclusion: Study revealed that 9.1% of patients developed wound infections following caesarean section procedures. Anemia, obesity, diabetes and emergency C-section were observed to be the commonest identified risk factors,