Risks factors FOR wound complications after cesarean section

Abstract

Objective: The primary outcome was to determine risks factors for wound complications after cesarean section. Secondary outcome was the management of these complications.

Study design: We performed a retrospective cohort study of consecutive cesarean deliveries performed at a secondary care facility between June 2017 and June 2019. Composite wound complications included infection, disruption and fluid collection occurring 30 days post-operatively. Medical records were reviewed and data including patient demographics, comorbidities, intra-partum characteristics were evaluated as potential risk factors for wound complications using multivariate logistic regression. Secondarily, post-operative management of wound complications was described.

Results: Among 1520 patients undergoing cesarean section during the period of study, 67 developed wound complications (4.4 %). Mean Duration of local wound care was 41.35 days (2-95). Mean number of wound care related visits in our hospital was 4.85(1-11). Multivariate logistic regression analysis showed 2 significant independant risk factors: preeclampsia with OR 5.60, 95 % CI 2.83, 11.11 (p:<0.001), and premature rupture of the membranes with OR 9.76, 95 % CI 2.13, 44.77 (p: 0.003).

Conclusion: Preeclampsia and premature rupture of the membrane were independent risk factors for wound complications after cesarean section. Information regarding higher rates of wound complications and preventive measures should be provided to high-risk women prior to surgery.

Keywords: Cesarean; Complications; Hematoma; Infection; Risk factors; Wound.