A Study On Surgical Site Infections Following Lower Segment Caesarean Section At A Tertiary Care Centre

Authors

  • Amalanshu Raman
  • Bichitra Nath Shukla
  • Rashmi Rashmi
  • Shalini Raman

Keywords:

Surgical Site Infections, Lower Segment, Caesarean Section, LSCS, PROM, PIH

Abstract

Background: Surgical Site Infections (SSIs) remain a leading cause of postoperative morbidity following lower segment cesarean sections (LSCS), especially in low- and middle-income countries. These infections contribute to prolonged hospital stays, increased healthcare costs, and adverse maternal outcomes.

Objective: To determine the incidence, risk factors, and demographic correlates of SSIs in patients undergoing LSCS at a tertiary care center over a one-year period.

Material and Methods: A prospective observational study was conducted on 400 women undergoing LSCS between April 2024 and April 2025. Postoperative follow-up was done for 7 days. Clinical signs of infection were assessed, and wound cultures were collected when indicated. Data were analyzed using descriptive statistics and chi-square tests to evaluate associations.

Results: The incidence of SSI was 8% (32 out of 400 cases). A significant proportion of SSI cases were associated with emergency surgeries, high BMI (≥25), anemia (Hb <11 g/dL), perioperative hyperglycemia (glucose ≥110 mg/dL), and socio-demographic factors such as low socioeconomic status and rural background. Key obstetric risk factors included PROM, PIH, and multiple vaginal examinations. Emergency LSCS accounted for 95% of all SSIs.

Conclusion: SSIs following LSCS are predominantly associated with modifiable risk factors, including anemia, hyperglycemia, and emergency procedures. Optimizing preoperative care and stricter aseptic protocols can significantly reduce the SSI burden

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References

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Kelemu A, Amlaku M, Feleke H, Birhanu W, Liknaw B. Surgical site infection and its associated factors following cesarean section. BMC. 2017;11(17):2-8.

Smaill F, Hofmeyr GJ. Antibiotic prophylaxis for cesarean section. Cochrane Database Syst Rev. 2002;(5):CD933.

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Al Jama FE. Risk factors for wound infection after LSCS. Qatar Med J. 2012;2012(2):26-31.

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. Dhar H. A study of post-caesarean section wound infections in Oman. Sultan Qaboos Univ Med J. 2014;14(2):e211.

. Callaghan W, Creanga A, Kuklina E. Severe maternal morbidity in the US. Obstet Gynecol. 2012;120:1029-36.

. Gupta S, Manchanda V, Sachdev P, et al. Risk factors for SSIs in LSCS cases. Indian J Med Microbiol. 2021;39(1):1-5

American College of Obstetricians and Gynecologists. Safe prevention of primary cesarean delivery. Obstet Gynecol. 2014;123(3):693–711.

. Karl W. Reducing the complications of cesarean section. Adv Obstet Gynaecol. 2017;20:141–52.

. Kelemu A, Amlaku M, Feleke H, Birhanu W, Liknaw B. Surgical site infection and its associated factors following cesarean section. BMC. 2017;11(17):2-8.

. Bhavani K, et al. A critical review of post-operative caesarean section sepsis. IAIM. 2017;4(11):153-9.

De D, Saxena S, Mehta G, Yadav R, Dutta R. Risk Factor Analysis and Microbial Etiology of Surgical Site Infection following LSCS. Int J Antibiotics. 2013;2013:283025.

. Gelaw K, Aweke AM. Surgical site infection and its associated factors following cesarean section: a cross-sectional study from Ethiopia. Patient Saf Surg. 2017;11:18.

. Wloch C, Wilson J. Risk factors for surgical site infection following caesarean section in England. BJOG. 2012;119(11):1324-33.

. Olsen MA, et al. Risk factors for SSI after low transverse CS. Infect Control Hosp Epidemiol. 2008;29(6):477-84.

. Jalil MHA, et al. SSIs following cesarean in a Jordanian teaching hospital. Sci Rep. 2017;7(1):12210.

Mhaske G, Vadhera P, Kalra K. Study of surgical site infection in patients undergoing caesarean section: A retrospective study. Int J Clin Obstet Gynaecol. 2020;4(1):350-3.

. Dhar H. A study of post-caesarean section wound infections in Oman. Sultan Qaboos Univ Med J. 2014;14(2):e211.

. Shrestha S, et al. SSI following cesarean section at Dhulikhel Hospital. Kathmandu Univ Med J. 2014;46(2):113-6.

. Dessu S, et al. Determinants of post-CS SSI in Ethiopia. PLoS ONE. 2021;16(4):e0250174.

. Jalil MHA, et al. SSIs following cesarean in a Jordanian teaching hospital. Sci Rep. 2017;7(1):12210.

. Mpogoro FJ, et al. Incidence and predictors of SSI post-CS in Mwanza, Tanzania. Antimicrob Resist Infect Control. 2014;3(1):25.

Al Jama FE. Risk factors for wound infection after LSCS. Qatar Med J. 2012;2012(2):26-31.

Gupta S, et al. Risk factors for SSIs in LSCS cases. Indian J Med Microbiol. 2021;39(1):1-5.

Callaghan W, Creanga A, Kuklina E. Severe maternal morbidity in the US. Obstet Gynecol. 2012;120:1029-36.

. ACOG. Safe prevention of primary cesarean delivery. Obstet Gynecol. 2014;123(3):693–711.

Filbert J, et al. Incidence and predictors of SSIs post-CS at Bugando Medical Centre, Tanzania. Antimicrob Resist Infect Control. 2014;3(25):1-10.

Karl W. Reducing the complications of cesarean section. Adv Obstet Gynaecol. 2017;20:141–52.

Smaill F, Hofmeyr GJ. Antibiotic prophylaxis for cesarean section. Cochrane Database Syst Rev. 2002;(5):CD933.

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Published

2025-07-17

How to Cite

1.
Raman A, Shukla BN, Rashmi R, Raman S. A Study On Surgical Site Infections Following Lower Segment Caesarean Section At A Tertiary Care Centre. J Neonatal Surg [Internet]. 2025Jul.17 [cited 2025Sep.20];14(32S):5642-9. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/8342

Issue

Vol. 14 No. 32S (2025): Journal of Neonatal Surgery

Section

Original Article

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