Primary cesarean section: factors related to postpartum infection

Four hundred sixty-five primary cesarean sections (10.4% of total deliveries) performed during 1977 and 1978 were reviewed and compared with 465 vaginal deliveries to ascertain factors that may be related to postpartum infection. The overall morbidity (19.7%) related to postpartum infection in the primary cesarean section group was statistically different from the 2.4% morbidity in the vaginal group. Cross comparisons of the effect of membrane status, use of internal electronic monitoring, development of postpartum anemia, duration of active labor, and difference in patient populations showed that internal monitoring had little or no effect on the development of postpartum endometritis. However, the development of postpartum anemia, increased time between membrane rupture and delivery, and, most important, a significant difference in patient populations were believed to be related to the development of postpartum endometritis in both groups.