TITLE:
Infectious Complications after Cesarean Delivery: Trends of Incidences, Risk Factors, and Prognosis in a Third Health Level Center in Africa. Case of Gabriel Touré Teaching Hospital
AUTHORS:
Youssouf Traoré, Ibrahima Téguété, Amadou Bocoum, Malado Gamby, Sidy Traore, Soumaila Sanogo, Seydou Zana Dao, Mamadou S. Traoré, Niani Mounkoro
KEYWORDS:
Fever, Postpartum, Cesarean, Endometritis, Risk Factor, Death, Mali
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.1,
January
4,
2018
ABSTRACT: Post
cesarean infections are the main sources of fever in the postpartum. We have
undertaken this study in an African health setting where conditions of working
are different from those in developed countries. Objectives: The objectives
of this survey were to appreciate incidences, risk factors and prognosis of
post cesarean infections. Method: We
conducted a randomized historical cohort study in the department of gynecology
and obstetrics of Gabriel Touré teaching hospital from 2010 to 2015. Data have
been analyzed using X2 or Fisher test according their application
conditions, p value Results: From 2010 to 2015 we performed 15,963 deliveries within 5263
cesareans sections (32.97%). According to all the deliveries, the global frequency of
infection fluctuates from 1.5% in 2010 to 2.1% in 2015. The main risks that
influenced the occurrence of post cesarean infections were: the context of
cesarean section (RR =
2.05; CI95% (1.35 - 3.11); p 0.01), the prolonged labor
(RR =
1.38; CI95% (1.05 - 1.81);
p 0.01), the length of
cesarean (RR =
3.00; CI95% (1.89 - 4.90); p 0.01), and genital bleeding
(RR =
1.50; CI95% (1.10 - 1.90); p 0.01). The complications
reported were endometritis (43.55%), wound infection (18.11%), breast infection
(32.05%), puerperal psychosis (9 cases). We recorded six cases of
pelviperitonitis and three cases of sepsis. Four cases of maternal death due to
septic shock have been recorded (1.43%). Conclusion: Post cesarean infections constitute a real
problem of public health in developing countries. In our survey, the main
factors of infections have been context of cesarean, prolonged labor and length
of cesarean. Endometritis, breast infection and wound infection are the major
complications after cesarean section. The respect of protocol of the management
of patients should permit to prevent this deadly complication.