Demographic profile, unplanned status and intraoperative situations increase surgical site infection in cesarean delivery: conclusions from a prospective study in central India.

BACKGROUND

Surgical site infection continues to be a significant source of morbidity and mortality especially in developing countries. Data pertaining to incidence and risk factors following obstetric surgeries are scarce. This study aims to identify risk factors and microbiological etiology of SSI in patients undergoing cesarean section in a teaching tertiary care hospital in Central India.

METHODS

450 in-patient women who underwent cesarean for various indications were enrolled for the study and followed up for 30 days. Patients who reported between July 2022 to June 2023 were included in study and analyzed as per CDC definition and methodology. Incidence, risk factors like rural location, patients who are referred, duration of rupture of membrane, timing of prophylactic antibiotic, duration of surgery and microbiological etiology for SSI were noted from data collected.

RESULTS

The incidence of SSI is 13.7%. Rural location (OR 2.08), low socioeconomic status (OR 3.1), multiparity (OR 3.0), obesity (OR 4.05), emergency status (OR 4.63), increased duration of rupture of membrane (OR 8.3), prolonged labor (OR 11.7) and increased preoperative stay (OR 4.24) due to associated morbidities are the risk factors for SSI identified by univariate logistic regression model. Increase in each hour duration of surgery and inappropriate timing of antibiotic prophylaxis increased the risk of SSI by nearly double.

CONCLUSION

Rate of SSI in cesarean is 13.7%. Low socioeconomic status, rural locations, emergency status of surgery, long intra-operative period and time of prophylactic antibiotic are major risk factors for SSI in cesarean delivery.

CLINICAL TRIAL

Not Applicable.