Risk Factors for Post-Operative Wound Infection in the Setting of Chorioamnionitis and Cesarean Delivery.

Risk Factors for Post-Operative Wound Infection in the Setting of Chorioamnionitis and Cesarean Delivery.

J Matern Fetal Neonatal Med. 2015 Jul 2;:1-20

Authors: Dotters-Katz SK, Feldman C, Puechl A, Grotegut CA, Heine RP

Abstract
OBJECTIVE: The objective of this study was to identify factors associated with an increased risk of post-operative wound infection in women with chorioamnionitis who undergo cesarean delivery.
METHODS: We conducted a retrospective cohort study of women with clinical chorioamnionitis who underwent cesarean delivery at a tertiary-care center between June 2010 and May 2013. Demographic data, labor & delivery details, and post-operative outcomes were collected. Women with and without post-operative wound infections were compared.
RESULTS: Of 213 women with clinical chorioamnionitis who underwent cesarean delivery, 32 (15%) developed wound infections. Women with wound infection were more likely to have a BMI greater than or equal to 40 (p=0.04), chronic hypertension (p=0.03), leukocytosis on presentation (p=0.046), or use tobacco (p=0.002). Women who received ertapenem postpartum were less likely to develop wound infection than those who did not receive antibiotics (p=0.02) or those that received ampicillin, gentamicin, and clindamycin (p=0.005).
CONCLUSIONS: Elevated BMI, tobacco use, chronic hypertension, and leukocytosis at admission were associated with an increased risk of wound infection. Ertapenem appeared to reduce the risk of post-operative wound infections in women who had chorioamnionitis and underwent cesarean delivery. This could be considered as a treatment option for this high-risk population.

PMID: 26135793 [PubMed - as supplied by publisher]