Introduction
C-sections, also known as cesarean sections or cesarean deliveries, involve incisions in a mother's abdomen and uterus to deliver the baby. They are carried out when a vaginal delivery is impossible or unsafe or when the mother or the baby's health is in jeopardy. If complications arise during labor during vaginal delivery or if one has certain medical conditions, one might require a C-section.
When Is a Cesarean Section Performed?
When any of the following circumstances take place, a planned C-section is performed:
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Cephalopelvic Disproportion (CPD): It is the medical term used when the baby's head or body is too big to fit through the pelvis safely or when the pelvis is too small to accommodate a baby of average size.
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Previous C-section: Although it is possible to give birth vaginally after a prior C-section, not everyone can do so. The type of uterine incision used during the prior C-section and the possibility of uterine rupture are two factors that may impact this. When expecting twins or more, a C-section may be necessary even though twins are frequently delivered vaginally.
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Placenta Previa: When this condition exists, the placenta is too low in the uterus and prevents the baby from leaving through the cervix.
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Transverse Lie: The infant is lying sideways or horizontally inside the uterus.
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Breech Presentation: It is when the baby is feet-or bottom-first in the uterus. Some medical professionals might try to turn the baby, but if unsuccessful, they will need to perform a C-section.
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Health Conditions: During vaginal birth, conditions like heart disease could worsen with labor. If the mother has genital herpes at the time of delivery, a C-section is required.
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Obstruction: Other factors for a C-section include a large uterine fibroid, a pelvic fracture, or the presence of specific congenital anomalies in the unborn child.
If any of the following circumstances appear during the labor, one might need an emergency C-section delivery:
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When the cervix dilates and stops, does not efface (or thin), or the baby stops moving through the birth canal, the labor is not progressing, also known as prolonged labor.
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The umbilical cord is around the baby's neck or body or gets tangled up between the baby's head and the mother's pelvis, causing umbilical cord compression.
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Umbilical cord prolapse can occur when before the baby is born, the umbilical cord emerges from the mother's cervix.
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Placental abruption occurs when the placenta separates from the uterine wall before the baby is born.
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Fetal distress can occur during labor, the baby could experience issues that result in an irregular heartbeat.
What Is Postcesarean Infection?
An infection that develops after a C-section, also known as an abdominal or cesarean delivery, is known as a post-cesarean wound infection. It typically results from a bacterial infection at the surgical incision site.
One of the most frequent complications following a cesarean section is surgical site infection (SSI), which occurs between 3 to 15 % of the time. It puts a heavy financial burden on the health care system and the mother's physical and emotional strain. Additionally, up to 3 % more maternal deaths are linked to SSI. It is anticipated that the prevalence of SSI will rise concurrently with the global increase in cesarean section rates, explaining its clinical significance. Therefore, recognizing the effects and creating plans to diagnose, prevent, and treat SSI are crucial for lowering postcesarean morbidity and mortality because of its significant implications.
What Causes Postcesarean Infection?
Bacteria get into the wound and cause infections. An estimated 15 to 20 % of post-cesarean wound infections are caused by Staphylococcus aureus, also known as staph bacteria. Staph bacteria naturally inhabit human skin and hair. They can produce various infections when they multiply and get inside a wound. The following post-cesarean wound infections can be brought on by Staphylococcus aureus:
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Impetigo - Impetigo results in small, fluid-filled blisters that burst and leave crusts with a honey color behind. It can itch and hurt a lot.
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Abscesses - Abscesses are sores that form beneath the skin and are filled with pus and dead skin. They might hurt and feel warm.
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Cellulitis - An infection of the tissues beneath the skin is known as cellulitis. The symptoms, typically painful, red, and warm to the touch, can quickly spread from the incision site outward.
Infections from wounds typically appear four to seven days later. The strep bacteria, also known as streptococcus, may be the cause; if the symptoms appear within 28 hours. Erysipelas may result from strep infections. This particular form of cellulitis also affects the lymphatic system. Erysipelas in women usually appears as shiny, red, raised lesions with clear margins.
Among the other bacteria that can infect cesarean wounds are:
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Ureaplasma urealyticum.
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Staphylococcus epidermidis.
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Enterococcus faecalis.
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Escherichia coli.
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Proteus mirabilis.
A person might mistake a wound infection for other post-cesarean delivery complications that can also affect the wound. These consist of the following:
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Hematomas, or blood pockets that may develop close to the wound
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Seromas, or fluid-filled pockets, may develop around the wound
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Wound dehiscence is the separation of wound tissues along the incision line.
What Are the Signs and Symptoms of Postcesarean Infection?
After a cesarean delivery, monitoring the wound's appearance closely is vital, and following the doctor's postoperative instructions is vital. After being discharged from the hospital, if one experiences any of the symptoms below, call the doctor for advice or seek medical attention:
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Severe abdominal pain.
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Pus discharge from the incision site.
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Redness at the site of the incision.
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Swelling at the incision site.
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Pain at the incision site that does not go away or worsens.
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Fever < 100.4 ºF (38 ºC).
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Pain during urination.
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Foul-smelling vaginal discharge.
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Heavy bleeding.
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Bleeding with large clots.
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Leg pain or swelling.
How Is Postcesarean Infection Diagnosed?
Some post-cesarean wound infections are treated before a patient is allowed to leave the hospital. However, many post-cesarean wound infections manifest within the first few weeks following delivery. Because of this, most of these infections are discovered during follow-up visits. A wound infection is identified by:
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The wound looks.
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Progress in healing.
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Presence of typical infection symptoms.
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Presence of specific bacteria.
The doctor might need to open the wound to diagnose the problem and provide proper care. The physician may use a needle to drain pus from the wound if pus is draining from the incision. The fluid may be sent to a lab to identify any bacteria present.
How Is Postcesarean Infection Treated?
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Antibiotics are used to treat the majority of post-cesarean wound infections. The particular antibiotic needed will be based on the type of bacteria causing the infection. Cellulitis is one example of a less serious infection that typically clears up with a few rounds of antibiotics.
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A doctor may advise a minor surgery to drain abscesses and infected fluids if the wound drains fluid or if it is separating rather than closing. When a wound is found to have dead tissue, the doctor will peel and scrape the layers of dead tissue away until they reach healthy tissue. A physician will also examine the area's tissues to ensure they are in good condition during this procedure.
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Following the procedure, the doctor will apply an antiseptic and cover the area with gauze. Some varieties of gauze have antimicrobial qualities that eliminate bacteria and stop the spread of infection.
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The medical staff will monitor the women and their wounds for any indications of infection or changes in their symptoms. After returning home, women and those close to them should check the area for infection.
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Immediately after the procedure, a doctor will typically schedule follow-up appointments to assess how the wounds heal.
Conclusion
The number of cesarean sections performed is increasing these days. Although infections can delay healing, post-cesarean infections are typically treated by doctors using a combination of antibiotics, minor surgery, good hygiene, and wound care. If any signs of infection are noticed, a doctor must be consulted because infections can result in serious complications. Infection following a cesarean delivery can be quickly treated, and the patient can recover in a few weeks.
