Reducing post-cesarean sepsis: Current best practice in prevention and treatment

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• Cesarean section is the most common global surgery, associated with positive outcomes when indicated.
• Rising cesarean rates correlate with increased post-cesarean sepsis, specifically surgical site infections (7% incidence worldwide).
• Post-cesarean sepsis leads to prolonged hospitalization, further surgeries, increased maternal morbidity/mortality, and significant healthcare costs.

Purpose of the Study:

• To introduce a global practice guide for the prevention and treatment of post-cesarean sepsis.
• To advocate for evidence-based cesarean birth rates and increased vaginal birth after cesarean rates.
• To provide strategies for reducing maternal morbidity and mortality associated with post-cesarean infections.

Main Methods:

• Identifying pre-operative and intra-operative risk factors for post-cesarean sepsis.
• Implementing evidence-based infection prevention practices.
• Standardizing labor management and promoting vaginal birth after cesarean.

Main Results:

• The guide offers a framework for managing post-cesarean sepsis, addressing a gap in global practice.
• Preventive measures include prophylactic antibiotics, meticulous skin/vaginal preparation, and sterile technique adherence.
• Focus on optimizing cesarean rates and promoting vaginal birth after cesarean is crucial.

Conclusions:

• Adherence to the FIGO Committee on Infections During Pregnancy guide can significantly reduce post-cesarean sepsis.
• Comprehensive strategies encompassing risk factor identification and robust infection prevention are essential.
• Implementing these measures will improve maternal health outcomes and decrease associated healthcare burdens.