Objective This study aimed to develop a core outcome set of primary outcomes for studies involving cesarean deliveries with infectious morbidity outcomes. Study Design Authors reported primary outcomes from 11 Cochrane systematic reviews (SRs), 12 other SRs, and 327 randomized controlled trials (RCTs). These outcomes were condensed into 20 primary outcome groups. Next, a modified Delphi technique was used to gain consensus on key outcomes. Authors from included SRs were sent a questionnaire consisting of a free response and multiple-choice questions. These data were used to propose a set of core outcomes. Results The most frequent outcomes in RCTs were composite “infectious outcomes” (24%) with the second most common being endometritis (12%). The most common reported SR outcomes were wound infection (21%) and endometritis (16%). For the Delphi survey free response portion, wound infection (88%) and endometritis (79%) were the most commonly endorsed outcomes. Chosen list outcomes were maternal mortality (83%), wound infection (83%), wound complications (86%), and postpartum endometritis (80%). The proposed final core outcome set for cesarean trials was endometritis (primary outcome), maternal mortality, wound infection, wound complications, febrile morbidity, and neonatal morbidity. Conclusion Utilizing defined core outcomes in all studies of cesarean section can harmonize trial reports and allow data synthesis for meta-analyses.

Post-caesarean infectious complications result in significant maternal morbidity and mortality as well as increased readmissions and increased health care cost worldwide. This review provides a discussion of several risk factors that have been identified which predispose women to post-surgical infection. We also provide an overview of strategies for infection prevention including antibiotics, surgical techniques and negative pressure wound therapy. Criteria for diagnosis of wound infection are provided, as well as appropriate treatment regimens. Given the impact of maternal post caesarean infection, it is important for women's health care providers to understand how to prevent these infections, as well as recognise and treat them.

INTRODUCTION: Marijuana is the most commonly used illicit drug in pregnancy and prevalence rates are reported to be 5–7%. With legalization of marijuana, there is concern that more women believe marijuana use is safe in pregnancy. The purpose of this pilot study was to determine prevalence of marijuana use in our high-risk obstetrics population. METHODS: An IRB approval was obtained. Pregnant women seen in the high-risk obstetrics clinic at University of Florida were invited to participate in an anonymous survey related to marijuana exposure. A total of 106 women were included in the study. RESULTS: More than a half (52.3%) of the women reported having used marijuana in the lifetime, 34.6% reported using marijuana prior to pregnancy, and 16.8% reported use after becoming pregnant. The prevalence rates of marijuana use varied by duration of pregnancy. Higher prevalence rates were noted for pregnancy of 12 weeks or less (18.2%) and 25 weeks or longer (19.4%); however, this was not statistically significant. Among the 7 women who reported using marijuana for recreational purposes, 6 used marijuana during pregnancy. Among all women who used marijuana prior to pregnancy, 48.7% continue to use after becoming pregnant and 51.3% quit. CONCLUSION: The prevalence of marijuana use in our high-risk obstetrics population was self-reported to be 16.8%, this is significantly higher than national self-reported data. Self-reported marijuana use did decrease when comparing use before and after identification of pregnancy. This pilot data illustrates the importance of continued research to determine adverse pregnancy outcomes related to marijuana exposure.

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