Determinants associated with post-cesarean operating site infections from January 01, 2013 To June 30, 2019 at the Brazzaville University Hospital Center

Abstract

Introduction: Contaminated clean surgery, caesarean section remains by far the most short-term surgical intervention, in obstetrics and gynecology, of the operating site infection (OSI) whose incidence varies between 3 and 15% in Africa. The risk of infection being less linked to the technique, there are factors which predisposed certain caesareans to its occurrence. This is how this study set itself the objective of analyzing the determinants of infections of the post-cesarean operating site at the University Hospital Center of Brazzaville.

Patients and Methods: Analytical cross-sectional study, conducted from January 01, 2013 to June 30, 2019 at university hospital of Brazzaville, comparing 230 caesareans having presented a post-caesarean OSI during hospitalization until the first 30 days of post-operative, to 230 Caesareans who did not present an OSI during the same period. The variables studied were preoperative, intraoperative and postoperative.

Results: Four hundred and eight caesareans having presented an OSI were collected among 1063 caesareans, either a prevalence of 38.4%. Post-cesarean OSI were dominated by endometritis (40%), superficial suppuration (22%) and pelviperitonitis (16%). In 22% of cases, it involved the associated forms. The determinants associated with post-cesarean OSI were pre, intra and post-operative. This was after multivariate analysis of: age less than 25 years (ORa = 2 [1.04-4.09]), level of primary education (ORa = 4.1 [1.4-11 , 8]), BMI> 30kg / m2 (ORa = 5.9 [1.2-27.1]), the RPM of more than 6 hours (ORa = 2.2 [1.1-4.1]) , stained amniotic fluid (ORa = 3.6 [1.6-7.6]), duration of cesarean section over 45 minutes (ORa = 21.1 [11.3-39.4]) and absence of bread-making (ORa = 2.5 [1.3-4.5]).

Conclusion: Post-cesarean OSI are common and multifactorial in origin. Their reduction requires considering the determinants associated with them.