Clinical profile of patients with post-caesarean wound infection: experience of Patan Hospital, Nepal

2020 ◽  
Vol 7 (1) ◽  
pp. 107-112
Author(s):  
Ekta Jaiswal ◽  
Paban Sharma ◽  
Alka Singh
Keyword(s):  
Health Care ◽  
Caesarean Section ◽  
Wound Infection ◽  
Infection Rate ◽  
Health Care Professionals ◽  
Caesarean Delivery ◽  
Antibiotic Sensitivity ◽  
Perinatal Period ◽  
Skin Closure ◽  
Coagulase Negative Staphylococci

Introduction: Would infection following caesarean delivery adds physical, psychological, and health burden to individual and health care system. This hospital based study aim to determine the rate of infection, the risk factors, pathogens and antibiotic sensitivity. Method: A prospective study was carried out to analyze the wound infection in women following caesarean delivery in the Department of Obstetrics and Gynecology, Patan Hospital, Nepal, between January 2018 to December 2018. The study was approved from the institutional review committee. Clinicodemographic data during perinatal period of caesarean delivery were descriptive analyzed in relation to wound infection. Result: Wound infection occurred in 102 (3.1%)of 3285 caesarean section (of total 7131 deliveries during the study period. The caesarean SSI rate was 3.1%, all were incisional SSI (84 superficial and 18 deep) and there were no organ-space SSI. Majority (81.3%) SSI cases were detected in emergency LSCS. Coagulase Negative Staphylococci was the most common organism isolated from wound swab. Routine postoperative antibiotics did not have a major impact in reducing wound infection rate. Multiple per vaginal examinations, prolonged rupture of membrane and staples for skin closure were more commonly associated with SSI. Conclusion: Reduction in caesarean rate is the major key factor for decreasing the post caesarean wound infection. Protocol should be developed and strictly implemented by all the health care professionals in order to minimize and prevent the infection rate after caesarean section.

scholarly journals Bacteriological analysis of infected wound and their antibiotic sensitivity following emergency caesarean section-a study of 100 cases

KYAMC Journal ◽  
2018 ◽  
Vol 9 (2) ◽  
pp. 61-64
Author(s):  
Sushmita Paul ◽  
Debashis Paul ◽  
Ashraful Haque ◽  
Bijan Kumar Nath ◽  
Md Rezaur Rahman Miah ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Wound Infection ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Emergency Caesarean Section ◽  
Klebsiella Pneumonia ◽  
Infected Wound ◽  
College Hospital ◽  
Cross Sectional ◽  
Emergency Caesarean

Background: Emergency caesarean section is one of the commonly performed operation in the department of gynae and obstetrics.Objectives: The aim and objective of the study was to evaluate the organisms responsible for post emergency caesarean wound infection and their antibiotics sensitivity.Materials & Methods: The study is a prospective type of cross sectional study where 100 patient of post emergency caesarean wound infection was evaluated during July 2012 to December 2012 (6 Month Duration) at Rajshahi Medical College Hospital (RMCH) Rajshahi. The wound swab was sent for culture and sensitivity test.Results: The peak incidence of wound infection to between 6th - 8th post operative day. In wound discharge shows various organism but 16% showed no growth. The most of the infected wound showed (48%) thick creamy pus and the organisms isolated is Staphylococcus. antibiotics mostly used were Ciprofloxacin, Cephradine and Metronidazole. This study revealed that maximum wound infection is due to S. aureus. Regarding antibiotic sensitivity of the cultured organisms, all of them are sensitive to Imepenem (100%). Staphylococcus aureus mostly sensitive to Flucloxacillin (79.16%). Ciprofloxacin sensitivity is found in 58.33% cases. E coli mostly sensitive to Imepenem (100%) followed by Ceftriaxone (53.84%). Klebsiella pneumonia found mostly sensitive to Imepenem (100%) followed by Ceftriaxone (75%) and Cephradine (50%).Conclusion: Selection of appropriate antibiotic is important to reduce post caesarean wound infection.KYAMC Journal Vol. 9, No.-2, July 2018, Page 61-64

scholarly journals Hematologic Malignancies in Pregnancy: Management Guidelines From an International Consensus Meeting

2016 ◽  
Vol 34 (5) ◽  
pp. 501-508 ◽  
Author(s):  
Michael Lishner ◽  
Irit Avivi ◽  
Jane F. Apperley ◽  
Daan Dierickx ◽  
Andrew M. Evens ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Pregnancy Termination ◽  
Perinatal Period ◽  
Hematologic Malignancies ◽  
Consensus Meeting ◽  
Care Providers ◽  
International Consensus ◽  
Management Guidelines

Purpose The incidence of hematologic malignancies during pregnancy is 0.02%. However, this figure is increasing, as women delay conception until a later age. Systemic symptoms attributed to the development of a hematologic cancer may overlap with physiologic changes of pregnancy. A favorable prognosis is contingent upon early diagnosis and treatment. Therefore, a high index of suspicion is required by health care providers. Although timely, accurate diagnosis followed by appropriate staging is essential and should not be delayed due to pregnancy, management guidelines are lacking due to insufficient evidence-based research. Consequently, treatment is delayed, posing significant risks to maternal and fetal health, and potential pregnancy termination. This report provides guidelines for clinical management of hematologic cancers during the perinatal period, which were developed by a multidisciplinary team including an experienced hematologist/oncologist, a high-risk obstetrics specialist, a neonatologist, and experienced nurses, social workers, and psychologists. Methods These guidelines were developed by experts in the field during the first International Consensus Meeting of Prenatal Hematologic Malignancies, which took place in Leuven, Belgium, on May 23, 2014. Results and Conclusion This consensus summary equips health care professionals with novel diagnostic and treatment methodologies that aim for optimal treatment of the mother, while protecting fetal and pediatric health.

scholarly journals PATIENTS NEED TO RECEIVE THE SAME KIND OF INFORMATION ABOUT THE SAME ISSUE FROM EACH PROFESSIONAL

2021 ◽  
Vol 4 ◽  
pp. 265-273
Author(s):  
Ilze Ansule ◽  
Anda Kīvīte - Urtāne ◽  
Inga Millere
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Perinatal Period ◽  
Maternity Hospital ◽  
Postnatal Period ◽  
Communication Process ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
To Receive ◽  
Validated Instrument

The questionnaire has been developed from a validated instrument “Women’s Experience of Maternity Care” (author - National Health Service, (Great Britain, 2019) and adapted to the situation in Latvia. The permission to use it has been obtained from authors. The questionnaire is meant for women regardless of their health status during the perinatal period or who have no co-morbidities, diagnosed in perinatal period of care. The questionnaire is designed to find out patients' experiences of receiving healthcare and its compliance with the guidelines, identifying potential problems and creating opportunities to correct them. There were 50 patients in Maternity Hospital postpartum unit interviewed. 12 of them were women living with HIV. Results. One of five main comment themes was - patients felt the need to receive the same kind of information about the same issue from all health care professional regardless of staff changes on call. The women point out that they have no problems with content in communication process during intranatal period, at labor unit. The problem with different kind of information about the same matter is emerging in postpartum period, at maternity unit. This issue is bothering both groups of patients in postnatal period, those women who live with HIV and those who have no co-morbidities, diagnosed in perinatal period. This shows that there is different kind of knowledge and professional skills among health care professionals, even if they work in the same field, the same hospital and the same unit. There should be done more research to identify the source of this problem. Is it the different experience, knowledge, informational field where professionals seek for information or totally different reason for this phenomena. 

scholarly journals Prospective Analysis of Wound Infection Following Cesarean Section

2020 ◽  
Author(s):  
Sahrun Al Shukkur ◽  
Bharathi Rao ◽  
Sabah Mohd Zubair
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Infection ◽  
Caesarean Delivery ◽  
Suture Material ◽  
Methicillin Resistance ◽  
Subcutaneous Tissue ◽  
Surgical Site Infections ◽  
Categorical Variables ◽  
P Value ◽  
Skin Closure

Abstract Background: To study the risk factors among women who develop postoperative wound infection following caesarean section, and to analyze the microbiological pattern and antibiotic sensitivity. Method: This prospective hospital-based cross-sectional study conducted in government Lady Goschen Hospital, Mangalore, between October 2016 to March 2018, enrolled women who developed surgical site infections (SSI) within 30 days of caesarean delivery performed in the hospital. Descriptive statistics were used for socio-demographic variables and appropriate univariate and multivariate analysis used to find the association between continuous and categorical variables with a p-value of <0.05 taken as statistically significant.Results: Out of 4540 cesarean deliveries, 52 (1.1%) cases developed SSI. Surgical site infections were found significantly associated with maternal age above 25years, BMI>27Kg/m2 (p<0.001), hypertension, diabetes (p<0.001), the urgency of caesarean delivery, prolonged operative duration, technique and suture material (p<0.001) used. Poliglecaprone (monofilament) was found suitable for subcutaneous tissue and skin closure. Out of 38 cases with microbial growth, 52% cultured Staphylococcus aureus with 60% displaying methicillin resistance, followed by Diphtherioids (22%) and Pseudomonas (10.5%). Majority isolates showed higher sensitivity to Linezolid, Clindamycin and Vancomycin.Conclusion: Apart from maternal factors, the surgeon’s operative skill & technique, and suture material also contribute significantly to the development of SSI. A developing trend towards resistance to higher antibiotics was noted among Methicillin-resistant Staphylococcus aureus. Gentamicin and Linezolid were found as effective as second-line agents. Hence maintenance of quality asepsis and a hospital-based antibiotic policy is vital.

Caesarean section wound infections and antibiotic use: a retrospective case-series in a tertiary referral hospital in The Gambia

2017 ◽  
Vol 48 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Alex Aulakh ◽  
Patrick Idoko ◽  
Suzanne T Anderson ◽  
Wendy Graham
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Infection Rate ◽  
Wound Infection Rate ◽  
The Gambia ◽  
Referral Hospital ◽  
Wound Infections ◽  
Preoperative Antibiotic Prophylaxis

Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics. The wound infection rate found is likely to be an underestimate owing to loss to follow-up. The adherence to international guidelines regarding preoperative antibiotic prophylaxis needs to be improved.

scholarly journals Caring for Mothers: A Narrative Review on Interpersonal Violence and Peripartum Mental Health

2021 ◽  
Vol 18 (10) ◽  
pp. 5281
Author(s):  
Marianna Mazza ◽  
Emanuele Caroppo ◽  
Giuseppe Marano ◽  
Daniela Chieffo ◽  
Lorenzo Moccia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Interpersonal Violence ◽  
Perinatal Period ◽  
Narrative Review ◽  
Adverse Health Outcomes ◽  
Bonding Failure ◽  
Perinatal Health Care ◽  
Violence During Pregnancy ◽  
Provide Health Care

Interpersonal violence in the perinatal period is frequent and should be considered a prominent health issue due to the risk of escalation of violence and the significant impact on mothers’ parenting after childbirth. Domestic violence during pregnancy can be associated with fatal and non-fatal adverse health outcomes due to the direct trauma to a pregnant woman’s body and to the effect of stress on fetal growth and development. Emotional violence is a risk factor for prenatal and/or postpartum depression. Recent studies focusing on abusive situations during peripartum and possible preventive strategies were identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All of the available literature was retrospectively reviewed with a special attention to peer-reviewed publications from the last ten years. Results of the present narrative review suggest that perinatal health care professionals (general practitioners, gynecologists, obstetricians, psychologists, psychiatrists) should promptly detect interpersonal violence during and after pregnancy and provide health care for pregnant women. It seems pivotal to guarantee psychological care for abused women before, during, and after pregnancy in order to prevent the risk of depressive symptoms, other mental or physical sequelae, and mother-to-infant bonding failure. There is an urgent need for multifaceted interventions: programs should focus on several risk factors and should design tailored care pathways fitted to the specific needs of women and finalized to support them across the lifespan.

scholarly journals Which is better for pfannensteil skin incision closure in caesarean section? Interrupted mattress suture or continuous subcuticular suture

2020 ◽  
Vol 9 (9) ◽  
pp. 3711
Author(s):  
Shridevi A S. ◽  
Madhusoodana R. Bhovi ◽  
Prema Prabhudeva ◽  
Renuka . ◽  
Camelia Maitra
Keyword(s):  
Patient Satisfaction ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Skin Wound ◽  
Wound Complications ◽  
Skin Closure ◽  
Pain Level

Background: Caesarean delivery is one of the most commonly performed operations in obstetrics. Postoperative comfort of the woman largely depends on the method of skin closure. Wound complications from caesarean delivery such as dehiscence or infection cause a significant emotional and economic burden in obstetric care. There are many methods and techniques for skin wound closure in caesarean section. Each technique has its own advantages and disadvantages. The aim and objective of this study was to compare the wound outcomes in Pfannensteil incisions closed with mattress sutures using nonabsorbable suture and subcuticular sutures using absorbable sutures in caesarean deliveries.Methods: It is a prospective observational study done on 216 consecutive pregnant women who were admitted to labor room for elective or emergency caesarean section. Patients undergoing caesarean section with Pfannensteil incision between February 2019 to October 2019 were included in this study. Among 216 women, 108 women had mattress sutures and 108 women had subcuticular sutures for skin wound closure. The primary outcome studied was wound complications including erythema, wound dehiscence, burst abdomen, infection and pain which was studied on postoperative day 3-7. The secondary outcome was assessed at 6 weeks follow-up in terms of pain, cosmetic appearance of scar and patient satisfaction about scar.Results: A total of 216 pregnant women undergoing caesarean section were studied who had similar baseline characteristics and risk factors. However, women with previous caesarean section were more in mattress group. The overall incidence of erythema, surgical site infection, wound dehiscence, resuturing and pain was more in mattress group and was statistically significant. During follow-up at 6 weeks, women with subcuticular sutures had cosmetically better scar and more satisfied with their scars than women with mattress sutures but the pain level was same in both groups.Conclusions: Authors conclude that compared to mattress sutures, subcuticular sutures cause significantly fewer wound complications and pain in postoperative period. Also, subcuticular sutures are associated with cosmetically appealing scars and higher patient satisfaction. But there was no difference in pain level at 6 weeks in both methods of skin closure.

scholarly journals Skin and subcutaneous fascia closure at caesarean section to reduce wound complications: the closure randomised trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amanda J. Poprzeczny ◽  
Rosalie M. Grivell ◽  
Jennie Louise ◽  
Andrea R. Deussen ◽  
Jodie M. Dodd
Keyword(s):  
Caesarean Section ◽  
Wound Infection ◽  
Randomised Trial ◽  
Skin Closure ◽  
Absorbable Suture ◽  
Group 4 ◽  
Suture Group ◽  
Group 3 ◽  
Group 2 ◽  
Fascia Closure

Abstract Background Wound infection is a common complication following caesarean section. Factors influencing the risk of infection may include the suture material for skin closure, and closure of the subcutaneous fascia. We assessed the effect of skin closure with absorbable versus non-absorbable suture, and closure versus non-closure of the subcutaneous fascia on risk of wound infection following Caesarean section. Methods Women undergoing caesarean birth at an Adelaide maternity hospital were eligible for recruitment to a randomised trial using a 2 × 2 factorial design. Women were randomised to either closure or non-closure of the subcutaneous fascia and to subcuticular skin closure with an absorbable or non-absorbable suture. Participants were randomised to each of the two interventions into one of 4 possible groups: Group 1 - non-absorbable skin suture and non-closure of the subcutaneous fascia; Group 2 - absorbable skin suture and non-closure of the subcutaneous fascia; Group 3 - non-absorbable skin suture and closure of the subcutaneous fascia; and Group 4 - absorbable skin suture and closure of the subcutaneous fascia. The primary outcomes were reported wound infection and wound haematoma or seroma within the first 30 days after birth. Results A total of 851 women were recruited and randomised, with 849 women included in the analyses (Group 1: 216 women; Group 2: 212 women; Group 3: 212 women; Group 4: 211 women). In women who underwent fascia closure, there was a statistically significant increase in risk of wound infection within 30 days post-operatively for those who had skin closure with an absorbable suture (Group 4), compared with women who had skin closure with a non-absorbable suture (Group 3) (adjusted RR 2.17; 95% CI 1.05, 4.45; p = 0.035). There was no significant difference in risk of wound infection for absorbable vs non-absorbable sutures in women who did not undergo fascia closure. Conclusion The combination of subcutaneous fascia closure and skin closure with an absorbable suture may be associated with an increased risk of reported wound infection after caesarean section. Trial registration Prospectively registered with the Australian and New Zealand Clinical Trials Registry, number ACTRN12608000143325, on the 20th March, 2008.

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