[Infections after Caesarean sections]

Hanne-Merete Eriksen, Anja Ramberg Saether, Hege Line Løwer, Siri Vangen, Reidar Hjetland, Hege Lundmark, Preben Aavitsland
Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række 2009 March 26, 129 (7): 618-22

BACKGROUND: All hospitals in Norway are required to participate in the Norwegian Surveillance System for Hospital-Acquired Infections (NOIS). Hospitals can choose to have from one to five given surgical procedures under surveillance, caesarean section being one of them. This article describes the incidence of surgical site infections after caesarean sections and identifies causes for such infections.

MATERIAL AND METHODS: A national protocol, was developed in accordance with the European protocol (HELICS). Patients undergoing a caesarean section (1 September - 30 November in 2005, 2006 or 2007) in the participating hospitals were included and followed-up for 30 days. Cases were identified in accordance to standardised case definitions. Potential risk factors as well as demographic and clinical data were recorded.

RESULTS: 3900 women were included. 290 infections were diagnosed (incidence 8.3 %) among the 3491 women who were followed up after discharge. Only 14 % of the infections were diagnosed during the hospital stay. Age higher than 29 years and contaminated wound class 3 were significantly associated with infection. Among the 54 women with an organ/space or deep infection, 20 were readmitted to the hospital and 11 were reoperated.

INTERPRETATION: One of 12 women who undergo a caesarean section develops a surgical site infection. The incidence of infections in Norway is lower than in many other European countries. We recommend hospitals to evaluate the preventive measures implemented at their institution.

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