IntroductionCesarean section (C/S) is considered one of the most commonly performed procedures among women. The maternal morbidity due to infection post-C/S reaches eight-fold higher than that of vaginal delivery. Our aim is to identify the incidence and risk factors of surgical site infection (SSI) among patients at King Abdul Aziz Medical City (KAMC), Jeddah, Saudi Arabia, in order to develop a strong strategy to reduce its occurrence. MethodsThis retrospective cohort study was conducted at KAMC, Jeddah. The study included a total of 387 women who underwent cesarean sections from January 2014 to December 2014. The data were collected consecutively by reviewing medical records of pregnant patients who underwent elective or emergency C/S. The risk factors studied included age, presence of underlying diseases, BMI, hemoglobin level, prophylactic antibiotics, pre-labor rupture of membrane, duration of induction of labor, type of C/S, type of uterine incision, duration of operation, type of anesthesia, estimated blood loss, type of organism, and the duration of hospital stay postoperatively. ResultsThe incidence rate of wound infections (WI) was 3.4% (13/387). The mean age score was 31.1±5.6 years, and the mean score of BMI was 32.7±6.2, where the majority were obese (255, 65.9%). More than half of the participants (205, 53.0%) had elective C/S, with mean hospitalization duration 2.5±1.3 days, and operation duration mean score 59.5±22.0 minutes. The majority (378, 97.7%) received antibiotics before the operation, where cefazolin was the main antibiotic (376, 97.2%). Only 38 (10%) cases had intra-operative complications, where the main complication was postpartum hemorrhage (18, 44.0%). The majority of WI were superficial (11 cases), the main organism was E. coli in four (36.4%) cases, followed by Staphylococcus aureus in three (27.3%) cases. There was a significant association between WI post-C/S and BMI, type of uterine incision, and induction of labor (P=006, P=0.003, respectively). ConclusionsThis study showed that WI post-C/S is associated with high BMI, prolonged induction of labor, and Pfannenstiel incision. Reducing the rate of SSI will help to reduce its morbidity by identifying the risk factors pre-pregnancy and encouraging the implementation of preconception counseling clinics and antenatal classes to educate and increase awareness among patients.

Background: Uterine fibroid is the most common benign pelvic tumor in women. Pyomyoma is a rare complication of uterine fibroid and potentially fatal if not treated with antibiotics and surgical intervention. Case Report: Initially the patient presented with heavy vaginal bleeding and fever, temperature of 38°C, pulse of 125 per minute. Ultrasound (US) revealed a large intramural fibroid measuring (11.8×11.2 cm). A CT revealed gas within the fibroid and pyomyoma was the most likely diagnosis. The patient was successfully treated with antibiotics and myomectomy. Microbiology results demonstrate clostridium ramosum as the causative organism conforming rare diagnosis of pyomyoma. Conclusion: Pyomyoma is rare but potentially fatal condition if not treated. It is usually associated with super-added infection. The most prominent symptom of the condition is fever with no obvious origin. Fever which is not responding to antibiotic is also an evident feature of pyomyoma. Although rare, it must be a differential diagnosis in postpartum women who present with pyrexia of unknown origin.