Abstract
BackgroundSurgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics. In Ethiopia, prevalence and root causes of surgical site infection post-Caesarean section are highly variable. This systematic review and meta-analysis estimate the overall prevalence of surgical site infection and its root causes among women undergoing Caesarean section in Ethiopia.MethodSystematic review and meta-analysis were conducted to assess the prevalence and root causes of surgical site infection in Ethiopia. The articles were searched from the databases such as Medline, Google Scholar and Science Direct. A total of 13 studies from different regions of Ethiopia reporting the prevalence and root causes of surgical site infection among women undergoing Caesarean section were included. A random effect meta-analysis model was computed to estimate the overall prevalence. In addition, the association between risk factor variables and surgical site infection related to Caesarean section were examined.ResultsThirteen studies in Ethiopia showed that the overall prevalence of surgical site infection among women undergoing Caesarean section was 8.81% (95% CI: 6.34–11.28). Prolonged labor, prolonged rupture of membrane, presence of anemia, presence of chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue, and general anesthesia were significantly associated with surgical site infection post-Caesarean section.ConclusionPrevalence of surgical site infection among women undergoing Caesarean section was relatively higher in Ethiopians compared with the report of center of disease control guideline. Prolonged labor, prolonged rupture of membrane, presence of anemia, chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue and/or general anesthesia were significantly associated with surgical site infection post-Caesarean section.
Highlights
Surgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics
Thirteen studies in Ethiopia showed that the overall prevalence of surgical site infection among women undergoing Caesarean section was 8.81%
Four of the studies were conducted in countries other than Ethiopia: Nigeria [23], Characteristics of original articles A total of 13 original studies that reported the prevalence of Surgical site infection (SSI) among women undergoing Caesarean section (C/S) and its root causes were included in this systematic review and meta-analysis
Summary
Surgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics. Caesarean section (C/S) is a surgical practice where a neonate is born via an incision through both the abdominal wall and uterus It is the most frequent surgical procedure in obstetrics, occurring in approximately 15% of all deliveries, but ranges from approximately 3.5% across the African continent to 29.2% in Latin America [1]. Women undergoing Caesarean deliveries have a 5 to 20-fold greater chance of getting an infection compared with women who give birth vaginally These SSIs postCaesarean birth can occur in the pelvic organs, around the surgical incision, and sometimes the uterine wall [10]. Maternal morbidity related to infections post-C/S is eight times higher than post-vaginal delivery [11]
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