Koigi-Kamau R, Kabare L W, Wanyoike-Gichuhi J
Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya.
East Afr Med J. 2005 Jul;82(7):357-61.
To determine the incidence of post-caesarean wound infection.
Prospective descriptive study.
Maternity unit of Kiambu District Hospital in Central Province of Kenya.
All women undergoing caesarean delivery during the study period.
Overall incidence of post-caesarean wound infection, relationship between incidence and socio-demographic characteristics, pre-operative labour events, intrapartum events as well as HIV status.
The caesarean delivery rate was 7.8%. The overall post-caesarean wound infection rate was 19%. The incidence was 32% among single women as compared to 16% among married women, but this difference is not statistically significant. Among the 35% of women who laboured for more than 12 hours, the incidence of wound infection was 33% compared to 15% among those who laboured for 12 hours or less (p < 0.01). Rupture of membranes (ROM) for more than 12 hours was associated with high incidence of wound infection than among women in whom ROM was 12 hours or less (38% and 14% respectively, p < 0.001). Also duration of operation exceeding 60 minutes was associated with much higher incidence of wound infection (71%) compared to when the operation lasted 60 minutes or less (16%, p < 0.001). The incidence of post-caesarean wound infection does not appear to be significantly affected by HIV status or whether caesarean delivery was emergency or elective.
The overall post-caesarean wound infection rate is quite high. Prolonged pre-operative duration of labour, prolonged ROM and long duration of operation are associated with significantly higher incidence of wound infection. This should be seen against a background of a relatively low caesarean delivery rate and high incidence of prolonged labour. Strict labour management policies need to be inculcated in labour wards in District Hospitals in order to ensure timely caesarean delivery interventions, and hence, reduce post-caesarean wound infection rates.
确定剖宫产术后伤口感染的发生率。
前瞻性描述性研究。
肯尼亚中部省基安布区医院产科。
研究期间所有接受剖宫产的妇女。
剖宫产术后伤口感染的总体发生率、发生率与社会人口学特征、术前分娩情况、产时情况以及艾滋病毒感染状况之间的关系。
剖宫产率为7.8%。剖宫产术后伤口感染的总体发生率为19%。单身女性的发生率为32%，已婚女性为16%，但这一差异无统计学意义。在35%分娩时间超过12小时的女性中，伤口感染发生率为33%，而分娩时间为12小时或更短的女性中这一发生率为15%（p<0.01）。胎膜破裂（ROM）超过12小时的女性伤口感染发生率高于胎膜破裂12小时或更短的女性（分别为38%和14%，p<0.001）。此外，手术时间超过60分钟的伤口感染发生率（71%）远高于手术持续60分钟或更短的情况（16%，p<0.001）。剖宫产术后伤口感染的发生率似乎不受艾滋病毒感染状况或剖宫产是急诊还是择期的显著影响。
剖宫产术后伤口感染的总体发生率相当高。术前分娩时间延长、胎膜破裂时间延长和手术时间长与伤口感染发生率显著升高相关。这一情况应结合相对较低的剖宫产率和高延长产程发生率来看待。地区医院的产房需要推行严格的分娩管理政策，以确保及时进行剖宫产干预，从而降低剖宫产术后伤口感染率。
