Short report: Post-operative wound infections after the gentle caesarean section

Kim Bronsgeest; Vera E R A Wolters; Liv M Freeman; Arjan B Te Pas; Janneke H Kreijen-Meinesz; Kim E Boers

doi:10.1016/j.ejogrb.2019.03.002

Short report: Post-operative wound infections after the gentle caesarean section

Eur J Obstet Gynecol Reprod Biol. 2019 Oct:241:131-132. doi: 10.1016/j.ejogrb.2019.03.002. Epub 2019 Mar 8.

Authors

Kim Bronsgeest¹, Vera E R A Wolters², Liv M Freeman³, Arjan B Te Pas⁴, Janneke H Kreijen-Meinesz⁵, Kim E Boers⁶

Affiliations

¹ Department of Obstetrics and Gynaecology, Haaglanden Medisch Centrum, Bronovolaan 5, 2597 AX, The Hague, the Netherlands. Electronic address: k.bronsgeest@hagaziekenhuis.nl.
² Department of Obstetrics and Gynaecology, Haaglanden Medisch Centrum, Bronovolaan 5, 2597 AX, The Hague, the Netherlands; Department of Gynaecology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
³ Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
⁴ Department of Paediatrics, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
⁵ Department of Paediatrics, Haaglanden Medisch Centrum, Bronovolaan 5, 2597 AX, The Hague, the Netherlands.
⁶ Department of Obstetrics and Gynaecology, Haaglanden Medisch Centrum, Bronovolaan 5, 2597 AX, The Hague, the Netherlands.

PMID: 30879842
DOI: 10.1016/j.ejogrb.2019.03.002

Abstract

Objectives: Worldwide, the caesarean section (CS) is the most performed type of surgery and numbers are still rising. The gentle CS has become a more common procedure as it allows the parents to experience birth. Early and continuous skin-to-skin contact between the mother and her newborn is pursued. Parents are not separated from their newborns and stay with their child in the operation theatre and recovery room. However, data are limited on the incidence of surgical site infections (SSI) after gentle CS. The aim of our study was to examine the risk of postoperative wound infections after gentle CS. Secondary outcomes included other maternal complications and neonatal outcomes.

Study design: In this multicenter prospective cohort study, all women who underwent an elective gentle CS between January 2015 and January 2017 were eligible. Demographics, per procedural data, maternal complications and neonatal outcomes were collected. The follow-up lasted until six weeks post partum.

Results: Of the 243 performed CSs, two (0.8%) SSIs occurred; one superficial and one deep wound infection. One patient (0.4%) was readmitted for treatment of endometritis. In total, 20 (8.2%) maternal complications were identified. Median time to skin-to-skin contact was 3 minutes (IQR 2-4.25) with a median neonatal oxygen saturation 10 minutes after birth of 95% (IQR 92-98). Mean gestational age was 274 ± 4.1 days (39 + 1 weeks) and mean neonatal pH was 7.28 (±SD 0.07). All children had Apgar scores >7 at 5 minutes after birth. Neonatal admission occurred in 19 cases (7.8%) and neonatal readmission in 10 cases (4.1%).

Conclusion: The gentle CS seems to be a safe procedure for both mother and child and is not associated with an increased risk of surgical site infections or direct suboptimal neonatal outcomes. Therefore, more intensive mother-child interaction during CS is allowed.

Keywords: Family-centred caesarean section; Gentle caesarean section; Neonatal admission; Neonatal outcome; Postoperative wound infection; Surgical site infection.

Publication types

Multicenter Study

MeSH terms

Adult
Cesarean Section / adverse effects
Cesarean Section / methods
Cesarean Section / statistics & numerical data*
Female
Humans
Netherlands / epidemiology
Pregnancy
Prospective Studies
Surgical Wound Infection / epidemiology*
Surgical Wound Infection / etiology