Outcome of cesarean section in asymptomatic HIV-1 infection in Kampala, Uganda

Sepsis remains a major cause of morbidity and mortality in Mulago Hospital, Kampala, Uganda, following cesarean section (CS). The present study was designed to assess whether asymptomatic HIV infection could be contributing to the increased morbidity following emergency CS in the form of wound and genital tract infection (GTI) with consequent prolonged stay in the hospital.

Five hundred patients who had undergone emergency lower segment CS had their blood taken to check for HIV-1 serostatus on the first postoperative day. The patients were followed up for evidence of wound sepsis, defined as occult pus discharge on compression of the wound or removal of the closing stitches, GTI and duration of stay in the hospital after the operation.

There were 98 (20.5%) HIV-1 seropositive patients. The incidence of postoperative wound sepsis (P = 0.948, 95% confidence interval [CI] 0.56-1.86), GTI (P = 0.339, 95% CI = 0.74-2.39) as well as hospital stay >8 days (P = 0.327, 0.78-2.09) was not statistically significantly different between the infected and non-infected groups. Significant predisposing factors to postoperative morbidity were poor general condition on admission, dehydration, preoperative clinical anemia, and ruptured membranes prior to the operation.

Asymptomatic HIV-1 was not associated with increased postoperative morbidity following emergency lower segment cesarean section.