Infectious morbidity associated with cesarean section

Abstract

Introduction: Cesarean section is performed nowadays with increased frequency; however, this type of delivery is associated with infectious complications in up to 15% of the cases. Objective: To characterize the infectious morbidity associated with cesarean section at the Mariana Grajales Obstetrics and Gynecology University Hospital from 2008 to 2010. Methods: A retrospective case-control study was carried out with cesarean patients that presented infectious complications during this period. The sample was formed by 94 patients with post-cesarean sepsis, as the study group. The control group was formed with 94 non-septic patients who underwent cesarean section. Information was collected through a form; the data were taken from medical records and the record book of cesarean sections. The data were processed by a statistical program to make frequency tables in order to allow the analysis of variables. Results: During the study period, 6 033 caesarean sections were performed; 94 cases had infection for a rate of 1.55%. The average age was 31.7±4.2 years. Cesarean section was performed as emergency in 71.2% of women. The multiple vaginal examinations and the rupture of the membranes for more than 24 hours were significant factors associated with puerperal infection. The risk of infection was two times higher in patients intervened due to the prior cesarean section and cephalopelvic disproportion. Surgical wound infection (53.2%) and endometritis (32%) were the most frequent locations. Staphylococcus aureus (34%) and Escherichia coli (17%) were the most frequent isolates. Conclusions: Despite the increased amount of cesarean delivery, the post-cesarean infection rates showed a downward and stable trend. However, there are still preventable and avoidable factors on which we must continue working to make cesarean section as safe as possible for mothers.