Postpartum Infection in Morbidly Obese Women After C-Section: Does Early Prophylactic Oral Antibiotic Use Make a Difference?Yeeles H1*, Trinick S1, Childs C2, Soltani H2 and Farrell T3
- *Corresponding Author:
- Dr.Hannah Yeeles
Rotherham General Hospital, Rotherham
NHS Foundation Trust, Moorgate Road
Rotherham, S60 2UD, UK
Tel: +44 (0)114 225 5444
E-mail: [email protected]
Received date: April 14, 2014; Accepted date: June 28, 2014; Published date: July 02, 2014
Citation: Yeeles H, Trinick S, Childs C, Soltani H, Farrell T (2014) Postpartum Infection in Morbidly Obese Women After C-Section: Does Early Prophylactic Oral Antibiotic Use Make a Difference? J Women’s Health Care 3:172. doi:10.4172/2167-0420.1000172
Copyright: © 2014 Yeeles H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The rising prevalence of morbid obesity particularly in women coupled with a higher likelihood of having a caesarean section (C-section) birth and an increased risk of Surgical Site Infection (SSI) places wound assessment among priority areas in maternity care. There is a level of ambiguity about the efficacy of routine preventative care pathways particularly in morbid obese women with regards to SSI after caesarean section. A pilot study was therefore undertaken to explore the number of women with a C-section infection in a cohort of morbidly obese women during six weeks postpartum against a background of standard care early antibiotic prophylaxis and skin closure practice. A short questionnaire was sent to 59 women with an early pregnancy BMI ≥ 40 who gave birth via C-section in a large maternity unit in Sheffield, UK. Of 39 participants who responded, 20 (51%) developed a post-operative wound infection within 6 weeks postpartum. Infections were higher in the women who had emergency C-section births (14/24, 60%). There was no significant difference in wound infection risk with respect to wound closure material (Chi-square = 0.298, p-value = 0.86) or the use of oral prophylactic antibiotic after birth (Chi-square = 0.2053, p-value = 0.650). Although all the women received routine IV antibiotics before C-section, only 26/39 received the 5 day oral antibiotic prophylaxis after birth. Six of 13 women who did not receive postpartum oral antibiotics (46%) developed a SSI. In summary, over half of morbidly obese women who delivered by C-section developed a wound infection, despite receiving prophylactic antibiotics. We acknowledge the limitations of these results from a small sample retrospective observational study. However this may indicate that SSI imposes a greater risk because of a lack of antibiotic prophylaxis efficacy and requires further investigation.