Caesarean section in a tertiary care centre

Authors

  • Rina V. Patel Department of Obstetrics and Gynecology, SVP Hospital and NHL Medical College, Ahmedabad, Gujarat, India
  • Divyanshi J. Shani Department of Obstetrics and Gynecology, SVP Hospital and NHL Medical College, Ahmedabad, Gujarat, India
  • Parul T. Shah Department of Obstetrics and Gynecology, SVP Hospital and NHL Medical College, Ahmedabad, Gujarat, India
  • Dipali Pandey Department of Obstetrics and Gynecology, SVP Hospital and NHL Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20203288

Keywords:

Breast abscess, Infectious morbidities, Surgical site infection, Urinary tract infection

Abstract

Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.

Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.

Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.

Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.

References

Charoenboon C, Srisupundit K, Tongsong T. Rise in cesarean section rate over a 20-year period in a public sector hospital in northern Thailand. Arch Gynecol Obstet. 2013;287(1):47-52.

Miller ES, Hahn K, Grobman WA. Consequences of a primary elective cesarean delivery across the reproductive life. Obstet Gynecol. 2013;121(4):789-97.

Molina G, Weiser TG, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Azad T, et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA. 2015;314(21):2263-70.

Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk factors for surgical site infection after low transverse cesarean section. Infect Control Hosp Epidemiol. 2008;29(6):477-84.

Schneid-Kofman N, Sheiner E, Levy A, Holcberg G. Risk factors for wound infection following cesarean deliveries. Int J Gynecol Obstet. 2005;90(1):10-5.

Opøien HK, Valbø A, Grinde-Andersen A, Walberg M. Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study. Acta Obstet Gynecol Scand. 2007;86(9):1097-102.

Gibbs RS. Clinical risk factors for puerperal infection. Obstet Gynecol. 1980;55(Suppl 5):S178-S184.

Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Fetal Neonatal Med. 2016;705:1-5.

Taha O, Chappelle J. Optimal duration of urinary catheterization after cesarean delivery [17H]. Obstet Gynecol. 2018;131:91S.

Horan TC, Gaynes RP, Martone WJ, Jarvis WR. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13(10):606-8.

Puerperal sepsis. Available at: https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/puerperal-sepsis. Accessed on 20th February 2020.

Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A. Infectious diseases society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40(5):643-54.

Shea NL. Long-term-care-committee. Urinary tract infections in long-term-care facilities. Infect Control Hosp Epidemiol. 2001;22(3):167-75.

Bartlett JG, O'keefe P, Tally FP, Louie TJ, Gorbach SL. Bacteriology of hospital acquired pneumonia. Arch Intern Med. 1986;146(5):868-71.

Johanson WG, Jr., Pierce AK, Sanford JP, Thomas GD. Nosocomial respiratory infections with gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med. 1972;77(5):701-6.

Andrews CP, Coalson JJ, Smith JD, Johanson WG. Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury. Chest. 1981;80(3):254-8.

Lowy FD, Carlisle PS, Adams A, Feiner C. The incidence of nosocomial pneumonia following urgent endotracheal intubation. Infect Control. 1987;8(6):245-8.

Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-32.

Olsen MA, Butler AM, Willers DM, Devkota P, Gross GA, Fraser VJ. Risk factors for surgical site infection after low transverse cesarean section. Infect Control Hospital Epidemiol. 2008;29(6):477-84.

Couto RC, Pedrosa TM, Nogueira JM, Gomes DL, Neto MF, Rezende NA. Post‐discharge surveillance and infection rates in obstetric patients. Int J Gynecol Obstet. 1998;61(3):227-31.

Hebert PR, Reed G, Entman SS, Mitchel EF, Berg C, Griffin MR. Serious maternal morbidity after childbirth: prolonged hospital stays and readmissions. Obstet Gynecol. 1999;94:942-7.

Mah MW, Pyper AM, Oni GA, Memish ZA. Impact of antibiotic prophylaxis on wound infection after cesarean section in a situation of expected higher risk. Am J Infect Control. 2001;29:85-8.

Allen VM, O’Connell CM, Liston RM, Baskett TF. Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term. Obstet Gynecol. 2003;102:477-82.

Robinson HE, O’Connell CM, Joseph KS, McLeod NL. Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol. 2005;106:1357-64.

Asch DA, Nicholson S, Srinivas S, Herrin J, Epstein AJ, et al. Evaluating obstetrical residency programs using patient outcomes. JAMA. 2009;302:1277-83.

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Published

2020-07-23

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Original Research Articles