Atiya Fasih, Adnan Fasih.
Potential Predictors of Post-Caesarean Wound Morbidity and Characteristics of Microorganisms.
Infect Dis J Jan ;21(2):430-4.

Introduction: Worldwide rate of caesarean section has been increasing beyond the recommended level of 15% by World Health Organization. The short and long-term morbidities of the rising Caesarean section rate on the childbearing population are conflicting as compared with international standards. Wound morbidity increases length of hospital stay and is associated with increased costs to the healthcare system. Objective: To identify the potential predisposing risks factors for high Caesarean section rate, Caesarean section wound morbidity and characterize organisms causing wound infection and its relation between antenatal care. Design: Descriptive prospective study. Setting; Jinnah Medical College and Teaching Hospitals (JMCH), Department of Obstetrics & Gynecology, Karachi, Pakistan. Method: All the women, delivering by Caesarean section (both emergency and elective) at JMCH, from 1 January 2011 to 15 June 2012 were included. Data was collected, on a specially designed questionnaire after taking informed consent from the patients who developed post-Caesarean complications during the study period. The isolated microorganisms were identified along with antimicrobial susceptibility. Results: During the study period, there were 1012 deliveries with an overall Caesarean section rate of 38%. The rate of Caesarean section wound morbidity was 26%. In most of the patients, wound complication was disruption that was evident within first five days after delivery. Growth was yielded in 28% patients. Of 94 isolates, 41% were resistant to first generation cephalosporin and 15% were resistant to ampicillin, metronidazole and gentamicin. Conclusion: The frequency of caesarean section is high in our setup and increasing each year. Approximately, one-quarter of abdominally delivered patients developed wound complication. A significant portion of pathogens causing post Cesarean abdominal wall wound infection were resistant to prophylactic treatment and some to empirical treatment.

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