The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Rate of post-cesarean surgical wound infection and its related factors in women referred to Tabriz hospitals

Document Type : Original Article

Authors
Sara Dousti 1
Seyed Mehdi Haghdoost 2
1 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mahabad Branch, lslamic Azad University, Mahabad, lran.
2 Assistant Professor, Department of Infectious Diseases, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
10.22038/ijogi.2020.16615
Abstract
Introduction: Cesarean section is the most common surgery in obstetrics and gynecology. Post-cesarean surgical wound infection has irreversible complications. Lack of knowledge about its prevalence has prevented the adoption of preventive decisions in general policies of the health system. Therefore, this study was performed with aim to evaluate the rate of post-cesarean surgical wound infection and its related factors in women referred to Tabriz hospitals.
Methods: This descriptive cross-sectional study was performed on 315 women candidate for cesarean section in public and private hospitals of Tabriz from 2018 to 2019. Symptoms of surgical wound infection were recorded in post-cesarean section infection questionnaire. Data were analyzed by SPSS software (version 20) and Chi-square, Independent t-test and logistic regression. p < 0.05 was considered statistically significant.
Results: 79 participants (25.08%) had symptoms of surgical wound infection. Investigation of specific and effective risk factors on surgical wound infection indicated that variables such as gestational age (P=0.041), number of pregnancies (P=0.019), previous cesarean section (P=0.009), premature rupture of membrane (P=0.008), type of cesarean section (P=0.003), gestational diabetes (P=0.008) and body mass index (P=0.005) were significantly different between the two groups.
Conclusion: Post-cesarean surgical wound infection was observed in 25% of women and its risk factors included gestational age, number of pregnancies and previous cesarean section, premature rupture of membrane, emergency cesarean section, gestational diabetes, and high BMI.
Keywords
Cesarean Section
Infection
Risk Factor
  1. De Mucio B, Serruya S, Alemán A, Castellano G, Sosa CG. A systematic review and meta‐analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta. Int J Gynaecol Obstet 2019; 147(3):281-291.
  2. Aghamohamadi D, Gol MK. An Investigation Into the Effects of Magnesium Sulfate on the Complications of Succinylcholine Administration in Nulliparous Women Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial. International Journal of Women’s Health and Reproduction Sciences 2019; 7(4):520-525.
  3. Alvandfar D, Alizadeh M, Khanbabayi Gol M. Prevalence of pregnancy varicose and its effective factors in women referred to gynecology hospitals in Tabriz. Iran J Obstet Gynecol Infertil 2019; 22(9):1-7.
  4. Rafiei M, Saei Ghare M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed (Yazd) 2018; 16(4):221-234.
  5. Long Q, Kingdon C, Yang F, Renecle MD, Jahanfar S, Bohren MA, et al. Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review. PLoS Med 2018; 15(10):e1002672.
  6.  Fakhari S, Bile Jani I, Atashkhouei S, Khanbabayi Gol M, Soliemanzadeh S. Comparing the effect of hypotension treatment due to spinal anesthesia with ephedrine or phenylephrine on arterial blood gases and neonatal Apgar score during cesarean delivery in obese mothers: randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2019;22(10):12-20.
  7. Nuamah MA, Browne JL, Öry AV, Damale N, Klipstein-Grobusch K, Rijken MJ. Prevalence of adhesions and associated postoperative complications after cesarean section in Ghana: a prospective cohort study. Reprod health 2017; 14(1):143.
  8. Haghdoost M, Mousavi S, Khanbabayi Gol M, Montazer M. Frequency of Chlamydia trachomatis Infection in Spontaneous Abortion of Infertile Women During First Pregnancy Referred to Tabriz University of Medical Sciences by Nested PCR Method in 2015. International Journal of Women’s Health and Reproduction Sciences 2019; 7(4):526-530.
  9. Aghamohammadi D, Mehdinavaz Aghdam A, Khanbabayi Gol M. Prevalence of Infections Associated with Port and Predisposing Factors in Women with Common Cancers Under Chemotherapy Referred to Hospitals in Tabriz in 2015. Iran J Obstet Gynecol Infertil 2019; 21(11):7-13.
  10. Haas DM, Morgan S, Contreras K. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev 2014; (12):CD007892..
  11. Dahiya P, Gupta V, Pundir S, Chawla D. Study of Incidence and Risk Factors for Surgical Site Infection after Cesarean Section at First Referral Unit. International Journal of Contemporary Medical Research 2016; 3(4):1102-4.
  12. Garcell HG, Arias AV, Olivares DCR, Acosta PAC, Redonet EMS, Serrano RNA. Incidence of Surgical Site Infection and Compliance with Antibiotic Prophylaxis in Cesarean Section in a Community Hospital in Qatar. Avicenna J Clin Microbiol Infect 2017; 4(4):e11955.
  13. Arlier S, Seyfettinoğlu S, Yilmaz E, Nazik H, Adıgüzel C, Eskimez E, et al. Incidence of adhesions and maternal and neonatal morbidity after repeat cesarean section. Arch Gynecol Obstet 2017; 295(2):303-311.
  14. Sood G, Argani C, Ghanem KG, Perl TM, Sheffield JS. Infections complicating cesarean delivery. Curr Opin Infect Dis 2018; 31(4):368-376.
  15. Moulton LJ, Munoz JL, Lachiewicz M, Liu X, Goje O. Surgical site infection after cesarean delivery: incidence and risk factors at a US academic institution. J Matern Fetal Neonatal Med 2018; 31(14):1873-1880.
  16. Tierney N, LaCoursiere DY, Hebert S, Kelly TF, Lukacz ES. Incidence of wound complications after cesarean delivery: is suture closure better? J Matern Fetal Neonatal Med 2017; 30(16):1992-1996.
  17. Jasim HH, Sulaiman SAS, Khan AH, Dawood OT, Abdulameer AH, Usha R. Incidence and risk factors of surgical site infection among patients undergoing cesarean section. Clinical Medicine Insights: Therapeutics 2017; 9:1-7.
  18. Carter EB, Temming LA, Fowler S, Eppes C, Gross G, Srinivas SK, et al. Evidence-based bundles and cesarean delivery surgical site infections: a systematic review and meta-analysis. Obstet Gynecol 2017; 130(4):735-746.
  19. Mylonas I, Friese K. Indications for and risks of elective cesarean section. Dtsch Arztebl Int 2015; 112(29-30):489-95.
  20. Mueller NT, Whyatt R, Hoepner L, Oberfield S, Dominguez-Bello MG, Widen E, et al. Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity. Int J Obes (Lond) 2015; 39(4):665-70.
  21. Shree R, Park SY, Beigi RH, Dunn SL, Krans EE. Surgical site infection following cesarean delivery: patient, provider, and procedure-specific risk factors. Am J Perinatol 2016; 33(2):157-64.
  22. Chu K, Maine R, Trelles M. Cesarean section surgical site infections in sub-Saharan Africa: a multi-country study from Medecins Sans Frontieres. World J Surg 2015; 39(2):350-5.
  23. Kehl S, Weiss C, Dammer U, Baier F, Faschingbauer F, Beckmann MW, et al. Effect of Premature Rupture of Membranes on Induction of Labor: A Historical Cohort Study. Geburtshilfe Frauenheilkd 2017; 77(11):1174-1181.
  24. Yang XJ, Sun SS. Comparison of maternal and fetal complications in elective and emergency cesarean section: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics 2017; 296(3):503-12.
  25. Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Fetal Neonatal Med 2017; 30(1):8-12.
  26. Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol 2016; 37(1):88-99.
  27. Wang J, Chen K, Jin X, Li X, An P, Yang N, et al. Prognostic factors for cesarean section outcome of pregnant women with gestational diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr Obes 2019; 12:913-929.
  28. Bahrami Taghanaki HR, Hashemian M, Lotfalizadeh M, Noras MR. The relationship between Body Mass Index (BMI) and birth weight and some pregnancy outcomes. Iran J Obstet Gynecol Infertil 2016; 19(30):1-8.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 5
July 2020
Pages 60-66