[Incidence and risk factors of surgical site infection following caesarean section in a Tunisian maternity unit]. / Incidence et facteurs de risque de l'infection du site opératoire après césarienne dans une maternité de Tunisie.

INTRODUCTION: Surgical site infection (SSI) is a major health concern and is one of the most common complications following caesarean section, with an incidence of 3%-15%. With the worldwide increase in caesarean section rates, the incidence of SSI is expected to increase in parallel. This study was designed to estimate the incidence and determine the risk factors of SSI after caesarean section in an Obstetrics and Gynaecology department in the Kairouan region in Tunisia. METHODS: A prospective cohort study of all patients who delivered by caesarean section between December 2015 and February 2016 was conducted in the Kairouan Obstetrics and Gynaecology department. The clinical status of these women was monitored during the 30-day postoperative period (in the outpatients department, emergency room or they were contacted by phone). A multivariate logistic regression model was used to identify risk factors. RESULTS: Of the 714 patients admitted for caesarean delivery, 636 (89%) were monitored for 30 days. Thirty-two of these women were diagnosed with SSI, corresponding to an incidence of 5% (95% CI = 3.3%; 6.6%). 87.5% (n = 28) of SSI were superficial and 12.5% (n = 4) were complex (deep and organ/space). Multivariate logistic regression analysis identified the woman's age as a risk factor of SSI (RR = 1.07 for every year increment, 95% CI = 1.007; 1.17), whereas drainage was identified as a protective factor (RR = 0.16, 95% CI = 0.05; 0.48). CONCLUSION: This study identified the incidence and risk factors of postoperative infection following caesarean section. Prevention of these infections should be a public health priority.

[Evaluation of the compliance rate of partograph use in a Tunisian Maternity ward: a targeted clinical audit]. / Évaluation de la conformité de la tenue du Partogramme dans une maternité Tunisienne: audit clinique ciblé.

Partograph is an essential tool in routine delivery room practices. It is a written reflection of the quality of mother and child health management during delivery and in the immediate post-partum period. Our study aims to assess compliance rate of partograph use within our maternity ward and to propose areas for improvement of its quality. We conducted a retrospective clinical audit of 400 patients? medical records who gave birth on the labour ward at University of Kairouan from 1 January to 31 December 2014. The reference guidelines used were those from the French Health High Authority (2006) containing 29 criteria divided into 3 categories (PARTOten, PARTOobs, PARTOeve). The overall compliance rate (OCR) of partograph use in our audit was 55.9%. With regard to the first area, such as « La tenue du partogramme ¼ (partograph use, PARTOten) the overall compliance rate was 88, 9%. With regard to the second area, such as « la traçabilité du déroulement du travail ¼ (track labor progression, PARTOobs) the overall compliance rate was 51, 4%. With regard to the third area, such as « la traçabilité des actes, des évènements et des traitements au cours du travail ¼ (the tracing of actions, events and treatments during labor, PARTOeve) the overall compliance rate was 27.4%. Our study has helped identify several areas for improvement. The ultimate goal of this clinical audit was the improvement of professional practices. Therefore, we implemented an action plan (training, awareness raising?) followed by a review aimed to verify the continuity of the corrective actions.