Study of Various Baseline Factors and Pre-Operative Factors Affecting Surgical Site Infection in Caesarean Section

Abstract

Introduction: Caesarean section is one of the most commonly performed surgical procedure in hospitals. But it carries 5-20 fold increase risk of infection compared to vaginal delivery. Analysis of various baseline, intrinsic and extrinsic risk factors predisposing to surgical site infection is necessary to detect common links. obtained information is important to plan a strategy to reduce post caesarean wound infections and its complications.
 Material and Method: This is a prospective observational study enrolling 1500 sequentiall consenting subjects who had undergone caesarean section, on surgical site infection following caesarean section.
 Results: The cesarean section rate was found to be 41.2%.Subjects over 35 years of age had highest SSI rates of 16.7% and difference in SSI in subjects more than 35years was statistically significant (p value = 0.04)
 (88.6%) of the total enrolled subjects undergoing LSCS were antenatally registered amongst which 3.3% developed SSI compared to 11.4% of the total subjects were antenatally unregistered amongst which 5.8% developed SSI (p value=0.04)
 1% of the total enrolled subjects undergoing LSCS had a history of gestational diabetes mellitus amongst which 33.3% had SSI , while 99% of the subjects did not have history of gestational diabetes amongst whom SSI incidence was 3.3% (p value <0.01) which is significant.
 7.6% of the total enrolled subjects undergoing LSCS had a history of hypertension amongst which 8.8% developed SSI compared to 92.4% of the subjects without hypertension had 3.2% SSI. (p value <0.01) there is a significant association of body mass index with SSI. (p value <0.01).
 There is significant association found between preterm rupture of membrane and SSI (p value <0.01).
 Conclusion: Strategies for the prevention of post operative BMI must aim to control mother’s pre-conceptual weight, their antenatal registration, follow standard intranatal mangement guidelines, timely administration of prophylactic antibiotic if decision to perform LSCS is to be taken.
 Keywords: Surgical site infection, caesarean section.