Surgical Site Infections Associated With Crash Cesarean Deliveries

In obstetrics, crash cesarean deliveries (CCDs) are emergent scenarios that pose imminent threat of death or disability to the fetus and mother. There is a gap in literature regarding CCD prevalence, management, and complication prevention.

To quantify the prevalence and factors associated with increased risk of surgical site infection (SSI) following CCD.

A case-control study using a random sample of 500 cesarean deliveries (CDs) performed between 2019 and 2021 at the Women's Hospital in Winnipeg, MB was performed. Cases of CCD complicated by SSI were identified and compared with controls who had a CCD without associated SSI.

Of the 500 CD sampled, 143 (28.6%) qualified as CCD. Of these, the incidence of SSI was 7.7% (n = 11). Duration of rupture of membranes (ROM) is associated with SSI following CCD, with duration of ROM being 63.7 ± 94.4 hours among cases (n = 11) compared to 12.4 ± 20.8 hours among controls (n = 132, P = 0.003). Administration of intrapartum antibiotics for indications excluding a positive Group B Streptococcus result, is also correlated with increased risk of infection following CCD, with antibiotics being administered prior to the CCD in 54.5% (n = 6) of CCD resulting in infections, as compared to 10.6% (n = 14) of CCD without (P = 0.0011).

SSIs are common following CCD, and this study identified both the prevalence of CCD and clinical characteristics that increase a patient's risk of infection following CCD. Optimal strategies to mitigate infections following CCD remain an important question for future research.