ABSTRACT
Background: Surgical site infection (SSI) following C-section is a common encountered problem and needs to be analysed. In this study we have determined the incidence, risk factors and common bacterial pathogens in surgical site infection (SSI) following C-section at a tertiary care centre.Methods: A hospital based prospective study conducted for a period of 6 months. Those women whose C-section was complicated by SSI within 5 days postoperatively were included in the study. Risk factors for SSI were identified and microbiological pattern was studied.Results: Out of 62 women whose C-section was complicated by SSI within 5 days post-operatively, during this study period post caesarian SSI incidence was 0.34%. In this study post C-section SSI found as high as 43.55%, in lower socio-economic status. Among all patients, un-booked were 62.90%, Referred patients were as high as 67.74%. SSI developed in 69.35% patients without preoperative antibiotic prophylaxis. C-section done in PROM in 64.50% and as an elective emergency 79.03%, blood transfusion needed in 59.68% and type of incision being transverse (Pfannenstiel) in 88.71%. Subcutaneous suture technique used in 75.81% and secondary healing occurred in 67.74%. Most common organism grown was CoNS (coagulase negative staphylococcus) 29.03% in SSI.Conclusions: To reduce SSI, the hospital infection control system and surgical site infection surveillance program has to be established. Knowing the prevalence and risk factors will help optimal precaution and standard surgical technique to reduce SSI, which causes increased hospital stay of patients.
ABSTRACT
Background: The most common cause of post-partum hemorrhage (PPH) is uterine atony. Treatment for atony follows a well-defined stepwise approach, including drugs and mechanical interventions followed by surgery as a last resort. Early use of intrauterine balloon tamponade is a way of limiting ongoing uterine blood loss while initiating other measures and can be readily implemented by providers with minimal training.Methods: This prospective interventional study was conducted in 112 consecutive patients attended department of obstetrics and gynecology, Gandhi Medical College and Associated Sultania Zanana Hospital, Bhopal, Madhya Pradesh, India, in one year of study period.Results: In this study most of the patients had gestational age >37 weeks [83 (74.1%)]. Most of the patients in the study had vaginal delivery [64 (57.1%)]. In 84 (75%) patients Bakri balloon was used followed by Burke balloon in 17 (15.2%) patients, condom catheter in 7 (6.2%) patients and CG balloon in 4 (3.6%) patients. Different types of balloons were used according to availability of balloon at the time of management. Most of the patients [71 (63.3%)] had trans-vaginal route of balloon placement and 41 (36.7%) patients underwent trans-abdominal balloon placement. Most of the patients 69 (61.65%), responded to tamponing within 20 minutes of balloon placement while 9 patients had negative tamponade and continued to bleed. Bakri balloon tamponade was most commonly used in 84 (75.0%) patients. CG balloon and condom catheter were used only in 4 (3.6%) and 7 (6.3%) patients respectively. Tamponading was effective and successful in 103 (92%) patients.Conclusions: PPH is still a leading but preventable cause of maternal morbidity and mortality. In the majority of cases, relatively simple methods are used to avert a disaster, although these are not always employed. Uterine tamponade using intrauterine balloons appears to be an effective tool in the management of PPH.