Abstract
Objectives
Worldwide, the caesarean section (CS) is the most performed type of surgery and numbers
are still rising. The gentle CS has become a more common procedure as it allows the
parents to experience birth. Early and continuous skin-to-skin contact between the
mother and her newborn is pursued. Parents are not separated from their newborns and
stay with their child in the operation theatre and recovery room. However, data are
limited on the incidence of surgical site infections (SSI) after gentle CS. The aim
of our study was to examine the risk of postoperative wound infections after gentle
CS. Secondary outcomes included other maternal complications and neonatal outcomes.
Study design
In this multicenter prospective cohort study, all women who underwent an elective
gentle CS between January 2015 and January 2017 were eligible. Demographics, per procedural
data, maternal complications and neonatal outcomes were collected. The follow-up lasted
until six weeks post partum.
Results
Of the 243 performed CSs, two (0.8%) SSIs occurred; one superficial and one deep wound
infection. One patient (0.4%) was readmitted for treatment of endometritis. In total,
20 (8.2%) maternal complications were identified. Median time to skin-to-skin contact
was 3 minutes (IQR 2–4.25) with a median neonatal oxygen saturation 10 minutes after
birth of 95% (IQR 92–98). Mean gestational age was 274 ± 4.1 days (39 + 1 weeks) and
mean neonatal pH was 7.28 (±SD 0.07). All children had Apgar scores >7 at 5 minutes
after birth. Neonatal admission occurred in 19 cases (7.8%) and neonatal readmission
in 10 cases (4.1%).
Conclusion
The gentle CS seems to be a safe procedure for both mother and child and is not associated
with an increased risk of surgical site infections or direct suboptimal neonatal outcomes.
Therefore, more intensive mother-child interaction during CS is allowed.
Keywords
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References
- Risks and benefits of the skin-to-skin cesarean section—a retrospective cohort study.J Matern Fetal Neonatal Med. 2017; 30: 159-163
- Postcesarean wound infection: prevalence, impact, prevention, and management challenges.Int J Womens Health. 2017; 9: 81-88
- Global guidelines for the prevention of surgical site infection.WHO Press, 2016 (Available at http://www.who.int/gpsc/global-guidelines-web.pdf?ua=1 [Accessed 28 November 2017])
- Arterial oxygen saturation and heart rate after birth in newborns with and without maternal bonding.Pediatr Int. 2016; 58: 993-997
- Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study.Bmj. 2008; 336: 85-87
Article info
Publication history
Published online: March 08, 2019
Accepted:
March 1,
2019
Received:
February 8,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
