Infectious complications after caesarean delivery

Abstract

Introduction. Cesarean delivery, also known as a C-section, is characterized by the delivery of a fetus through surgical incisions performed on both the abdominal wall (laparotomy) and the uterine wall (hysterotomy). Cesarean birth is crucial in some cases, but for most low-risk pregnancies, it poses a higher risk of morbidity and mortality compared to vaginal birth. Infections are a common complication following cesarean delivery. Puerperal infection refers to an infection in the genital tract, occurring during any stage of labor and extending up to the 42nd day postpartum, marked by two or more of these symptoms: incision pain, fever, purulent lochia, chills, and uterine subinvolution. Aim of study. Analysis of aspects of etiology, diagnosis, treatment and impact of puerperal infections. Methods and materials. Data from relevant articles from databases such as: NCBI, PubMed, Medscape, Oxford Academic were analyzed. Results. The global caesarean section rate, as reported by the World Health Organization, is on the rise and now represents more than 1 in 5 (21%) of all births. In the Republic of Moldova, over the past decade, the incidence of cesarean section procedures has risen from 14.3% in 2010 to 19.7% in 2020. Despite its benefits, a caesarean section can be complicated by serious issues. The incidence of short-term complications following cesarean delivery includes: ileus (10-20%), endometritis (6-11%), wound complications (1-2%), massive hemorrhages (2-4%), surgical injuries (0.2-0.5%), and thromboembolism (240 per 100,000 births). Pre-existing maternal conditions such as malnutrition, diabetes, obesity, severe anemia, bacterial vaginosis, and group B streptococcal infections, along with factors like prolonged rupture of membranes, multiple vaginal examinations, manual placental removal, as well as cesarean section, were identified as significant contributors to puerperal infection. Successful management of puerperal and postpartum infections post-cesarean section necessitates a multidisciplinary approach that involves antimicrobial therapy, wound care, and abscess drainage Conclusion. Accurate identification of risk factors and appropriate determination of indications for a caesarean section are pivotal for effective patient management in the postpartum period and for lowering the incidence of infectious complications fetus through surgical incisions performed on both the abdomi nal wall (laparotomy) and the uterine wall (hysterotomy). Cesarean birth is crucial in some ca ses, but for most low-risk pregnancies, it poses a higher risk of morbidity and mortality compared to vaginal birth. Infections are a common complication following cesarean delivery. Puerperal infecti on refers to an infection in the genital tract, occurring during any stage of labor and extending up to th e 42nd day postpartum, marked by two or more of these symptoms: incision pain, fever, purule nt lochia, chills, and uterine subinvolution. Aim of study. Analysis of aspects of etiology, diagnosis, treatment and impact of puerperal infections. Methods and materials. Data from relevant articles from databases such as: NCB I, PubMed, Medscape, Oxford Academic were analyzed. Results. The global caesarean section rate, as reported by t he World Health Organization, is on the rise and now represents more than 1 in 5 (21%) of all births. In the Republic of Moldova, over the past decade, the incidence of cesarean section procedur es has risen from 14.3% in 2010 to 19.7% in 2020. Despite its benefits, a caesarean section ca n be complicated by serious issues. The incidence of short-term complications following cesarea n delivery includes: ileus (10-20%), endometritis (6-11%), wound complications (1-2%), massive he morrhages (2-4%), surgical injuries (0.2-0.5%), and thromboembolism (240 per 100,000 births ). Pre-existing maternal conditions such as malnutrition, diabetes, obesity, seve re anemia, bacterial vaginosis, and group B streptococcal infections, along with factors like prolonged r upture of membranes, multiple vaginal examinations, manual placental removal, as well as cesare an section, were identified as significant contributors to puerperal infection. Successful management of puerperal and postpartum infections post-cesarean section necessitates a multidisciplinary approach that involves antimicrobial therapy, wound care, and abscess drainage Conclusion. Accurate identification of risk factors and appropriate determination of indications for a caesarean section are pivotal for effective pat ient management in the postpartum period and for lowering the incidence of infectious complications