Abstract
BackgroundPregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients.MethodFacility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015. A total of 384 women who had surgery for delivery were included in the study. The risk associated with SSIs was assessed by multivariate regression logistic analysis.ResultsThe age of the women ranged from 17 to 40 years with the mean age of 26 (±5) years. The rate of surgical site infection was 9.4%(36/384). The risk factors for surgical site infection were age less than 19 (OR = 3.5, 95%CI 1.17–10.01), preterm gestation age (OR = 4.225 95%CI 1.254–14.238), duration of labor ≥24 h (OR = 2.219 95%CI1.054–4.670), duration of rupture of membrane ≥12 h (OR = 5.99, 95% CI2.75–13.02),chorioamnionitis (OR = 9.743, 95%CI 3.077–30.848), vertical skin incision(OR = 4,95%CI 1.709–13.322), pre operation Hematocrit (OR = 6.4,95%CI1.021–40.137),perioperative blood transfusion(OR = 6.75,95%CI 2.47,18.49), abdominal hysterectomy(OR = 7.9,95%CI1.698–36.960), and diabetic mellitus (OR = 3.7,95%CI 1.112–12.519).ConclusionsObstetric ward of Assela teaching referral hospital are encouraged to use properly WHO surgical safety checklist and examine how to sensibly integrate these essential safety steps into their normal operative workflow. Prophylactic antibiotic administration should be provided within one hour before the surgical incision or within two hours if the patient is receiving vancomycin or floroquinolones.
Highlights
Pregnant women are at risk of infection during labor and delivery
Prophylactic antibiotic administration should be provided within one hour before the surgical incision or within two hours if the patient is receiving vancomycin or floroquinolones
Centers for Disease Control and Prevention’s (CDC’s) and National Healthcare Safety Network (NHSN) categorized Surgical Site Infections (SSIs) in to 3 groups. According to this classification Organ/ space SSIs involve any part of the anatomy and that must develop within 30 days after procedures but does not include incision body wall layers that was opened or manipulated during an operation
Summary
Pregnant women are at risk of infection during labor and delivery. Pregnant women are at risk of infection during labor and delivery; most infections of the female pelvic organs occur when normal flora of the female genital or gastrointestinal tract contaminate the normally sterile amniotic fluid and uterus [1]. Centers for Disease Control and Prevention’s (CDC’s) and National Healthcare Safety Network (NHSN) categorized Surgical Site Infections (SSIs) in to 3 groups. According to this classification Organ/ space SSIs involve any part of the anatomy and that must develop within 30 days after procedures (e.g. organ/space) but does not include incision body wall layers that was opened or manipulated during an operation. Incision SSIs involving only skin and subcutaneous tissue are grouped as superficial incision SSIs and incision involving the deeper soft tissue classified as deep incision SSI [3,4,5,6].
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