Cesarean Section Incision Complications and Associated Risk Factors: A Quality Assurance Project

Abstract

Background: Today in the United States, approximately 30% of deliveries are performed by cesarean section. Wound infections and other post-operative complications represent a frequent morbidity which may be improved with an understanding of local risk factors. Objective: This project used a retrospective analysis of cesarean section incision complications and infection events along with patient chart information to identify potential risk factors associated with incisional wound complications at our institution. Methods: ICD9 codes identified 618 cesarean sections from July 2012 through June 2013. Of these, 59 were excluded. Twelve different data elements were examined and complications were divided into two categories: presence of infection and presence of seroma/hematoma. Statistics included univariate analysis and multiple logistic regressions to identify an odds ratio for associations using P complications. Three of the five variables had a significant odds ratio: emergent cesarean section, stapled skin closure, and preeclampsia. Five logistic variables were included in another multiple logistic regression model for all wound infections. Two of the five variables had a significant odds ratio: BMI > 33.4 and preeclampsia. Conclusions: Cesarean section rates account for approximately 30% of deliveries, with significant maternal morbidity associated with incisional wound complications. This study found multiple significant risk factors for both wound complications and infections. Preeclampsia was an independent risk factor for both wound complications and infections.