Wound Infection following Caesarean Section in a University Teaching Hospital in South-East Nigeria

Abstract

Background: Caesarean section is a common operation in obstetric practice, but there is a general aversion to caesarean section amongst Nigerian women due to a myriad of reasons amongst which are its associated morbidity and mortality. Surgical site infection following caesarean section is both a major cause of prolonged hospital stay and the wide spread aversion to caesarean delivery in our environment.
Objective: To determine the risk factors for surgical site infection following caesarean section as well as the relative contribution of each of the risk factors at the Anambra State University Teaching Hospital, (ANSUTH) Awka.
Methodology: A retrospective case controlled study of patients delivered by caesarean section in Amaku General Hospital now ANSUTH from January 1^st, 2000 to December 31^st, 2011. The cases were the patients whose caesarean sections were complicated by surgical site infections, while those without surgical site wound infection served as controls. The hospital records were compared.
Results: Five hundred and nine patients with complete records were analyzed. Fifty-six (56) patients (11%) had complicating wound infection. Statistically significant risk factors for infection were: body mass index >25 (p=0.003), prolonged rupture of membranes (p=0.0003), prolonged operation time (p=0.0011), anaemia (p=0.0009) and blood transfusion (p<0.0001), multiple vaginal examinations during labour (p<0.0001) and long duration of labour prior to caesarean section (p<0.0001).
Conclusion: To make caesarean section more acceptable to women in our environment, efforts should be concentrated on strategies to prevent the risk factors.

Keywords: Awka, caesarean section, infection