Department of Midwifery, Mizan Aman Health Science College, Mizan, Ethiopia.
Department of Nursing, Wolkite University, Wolkite, Ethiopia.
PLoS One. 2021 Dec 31;16(12):e0261951. doi: 10.1371/journal.pone.0261951. eCollection 2021.
Maternal surgical site infection after cesarean delivery is a clinical problem which contributes to significant morbidity and mortality. In Ethiopia admissions following cesarean section due to surgical site infection have been routine activities of health care institutions but there is limited scientific evidence on both the magnitude of the problem and factors associated with it making prevention mechanisms less effective. Therefore, this study aimed to assess magnitude and risk factors of post-cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia.
Institution-based cross sectional study with retrospective chart review was conducted from September 10-30 /2020 at 3 randomly selected primary hospitals of east Gojjam zone. The data were entered in Epi data version 3.1 and exported to Statistical Package for Social Science Software version 26. Post-cesarean section surgical site infection was measured based on disease classification and definition of the term by Center for Disease Control and Prevention. After checking for presence of multicollinarity, presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi-variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of <0.05 in multivariable analysis were considered statistically significant.
From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI: (1.29, 4.09)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI: (1.49, 8.09)], rupture of membrane>12hrs[(AOR = 4.61,95%CI:(2.34,9.09)], hypertension[(AOR = 3.14,95%CI:(1.29,7.59)] and preoperative Hematocrit ≤30%[(AOR = 3.22,95%CI:(1.25,8.31)] were factors significantly associated with post-cesarean section surgical site infections.
Magnitude of post-cesarean section surgical site infection was a significant problem in primary hospitals. Minimizing prolonged labor; minimize early rupture of membrane, properly managing patients with comorbidities like hypertension, strengthen prophylaxis and treatment for anemia during antenatal care and raising awareness for rural residents can reduce the problem. Zonal police makers should give emphasis to reduce its burden.
剖宫产术后产妇手术部位感染是一个临床问题，会导致严重的发病率和死亡率。在埃塞俄比亚，由于手术部位感染而进行剖宫产的住院治疗一直是医疗机构的常规活动，但由于缺乏关于问题严重程度和相关因素的科学证据，使得预防机制的效果较差。因此，本研究旨在评估东戈贾姆地区初级医院剖宫产术后手术部位感染的发生率和危险因素。
这是一项在 2020 年 9 月 10 日至 30 日期间，在东戈贾姆地区随机选择的 3 家初级医院进行的基于机构的横断面研究，采用回顾性病历查阅的方法。数据输入 EpiData 版本 3.1，并导入到统计软件包 26 版进行分析。根据疾病分类和疾病预防控制中心对该术语的定义，测量剖宫产术后手术部位感染。在检查是否存在多重共线性后，通过逻辑回归分析计算因素与结局变量之间的存在和关联程度。在单变量逻辑回归分析中 P 值≤0.2 的因素被纳入多变量逻辑回归分析，在多变量分析中 P 值<0.05 的因素被认为具有统计学意义。
在 622 例接受剖宫产的女性的病历中，有 77 例（12.4%）发生了手术部位感染。农村居民（AOR=2.30，95%CI：（1.29，4.09））、产程>24 小时（AOR=3.48，95%CI：（1.49，8.09））、胎膜早破>12 小时（AOR=4.61，95%CI：（2.34，9.09））、高血压（AOR=3.14，95%CI：（1.29，7.59））和术前血细胞比容≤30%（AOR=3.22，95%CI：（1.25，8.31））是与剖宫产术后手术部位感染显著相关的因素。
初级医院剖宫产术后手术部位感染的发生率是一个严重的问题。通过缩短产程，减少早期胎膜破裂，妥善管理高血压等合并症患者，在产前护理中加强预防和治疗贫血，提高农村居民的意识，可以降低这个问题的发生率。地区警察部门应重视减轻其负担。
