Infectious Complications after Cesarean Delivery: Trends of Incidences, Risk Factors, and Prognosis in a Third Health Level Center in Africa. Case of Gabriel Touré Teaching Hospital

Abstract

Post cesarean infections are the main sources of fever in the postpartum. We have undertaken this study in an African health setting where conditions of working are different from those in developed countries. Objectives: The objectives of this survey were to appreciate incidences, risk factors and prognosis of post cesarean infections. Method: We conducted a randomized historical cohort study in the department of gynecology and obstetrics of Gabriel Touré teaching hospital from 2010 to 2015. Data have been analyzed using X 2 or Fisher test according their application conditions, p value < 1% has been considered significant. Results: From 2010 to 2015 we performed 15,963 deliveries within 5263 cesareans sections (32.97%). According to all the deliveries, the global frequency of infection fluctuates from 1.5% in 2010 to 2.1% in 2015. The main risks that influenced the occurrence of post cesarean infections were: the context of cesarean section (RR = 2.05; CI 95% (1.35 -3.11); p < 0.01), the prolonged labor (RR = 1.38; CI 95% (1.05 -1.81); p < 0.01), the length of cesarean (RR = 3.00; CI 95% (1.89 -4.90); p < 0.01), and genital bleeding (RR = 1.50; CI 95% (1.10 -1.90); p < 0.01). The complications reported were endometritis (43.55%), wound infection (18.11%), breast infection (32.05%), puerperal psychosis (9 cases). We recorded six cases of pelviperitonitis and three cases of sepsis. Four cases of maternal death due to septic shock have been recorded (1.43%). Conclusion: Post cesarean infections constitute a real problem of public health in developing countries. In our survey, the main factors of infections have been context of cesarean, prolonged labor and length of cesarean. Endometritis, breast infection and wound infection are the major complications after cesarean section. The respect of protocol of the management of patients should permit to prevent this deadly complication.

A comparative study of short-term post caesarean section complications in normal versus gestational diabetic mothers

“…In normal group SSI incidence was within expected range, though some studies showed higher incidence. 13,16,17,19 We found total 3 cases of respiratory tract infection and 5 cases of urinary tract infection. Among 5 cases of UTI 3 (8.11%) cases were found in GDM group.…”

Comparison between extraperitoneal and transperitoneal cesarean section: Retrospective case-control study

“…The most common complication after CS is surgical site infection (SSI), with the rate of other infections ranging from 2-16 % depending on the world region. Antibiotic resistance in the surgical site infection after CS is described [8,9], including resistance to methicillin and carbapenem [10]. Bogdanović et al reported a high prevalence of SSI following CS, and Enterococcus faecalis and Escherichia coli were the most common pathogens isolated in their study [11].…”

Maternal complications and associated factors among mothers who underwent a cesarean section at Gebretsadik Shewa general hospital: an institution based cross-sectional study

“…Various studies in Ethiopia indicated that maternal complication following cesarean section is higher and mainly related to medical illnesses during pregnancy, urgency of indication, and operation related factors (type of cesarean section performed, length of cesarean section and the type of anesthesia used) ( 19 , 20 ). It is also found that rural residency of the mother, prolonged labor, gestational age, previous history of obstetric complication, parity, and no antenatal care follow up are the contributing factors for an increased maternal complication following cesarean delivery ( 20 – 23 ).…”