Infectious Complications after Cesarean Delivery: Trends of Incidences, Risk Factors, and Prognosis in a Third Health Level Center in Africa. Case of Gabriel TouréTeaching Hospital

• 作者: Amadou Bocoum Ibrahima Téguété Malado Gamby Mamadou S. Traoré Niani Mounkoro Seydou Zana Dao Sidy Traore Soumaila Sanogo Youssouf Traoré
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: FEVER POSTPARTUM CESAREAN ENDOMETRITIS Risk Factor Death MALI
• 年，卷（期）: 2018,（1）
• 页码范围: 10-19
• 页数: 10页
• 分类号: R73

摘要

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.