POSTOPERATIVE MORBIDITY FOLLOWING CESAREAN DELIVERY

The current study was designed to determine the postoperative morbidity associated with Caesarean section and to compare the morbidity with the timing of the operation: elective versus emergency Caesarean section; subgroups of women delivered by emergency Caesarean section; women delivered during the first stage of labour versus those delivered during the course of the second stage. A retrospective review was conducted of the obstetric case record and the midwifery notes of all women delivered by Caesarean section over a 1-year period in a university teaching hospital (n=619). The variables used to measure postoperative morbidity included: wound infection, intrauterine infection, urinary tract infection, chest infection, pyrexia, urinary catheterization and postnatal blood transfusion. Only 9.5% of the women had no recorded morbidity in the postnatal period. Women delivered by emergency Caesarean section experienced a greater number of postnatal problems, an increased incidence of febrile morbidity, more blood transfusions in the postnatal period and a higher proportion had a urinary catheter left in situ after surgery. The incidence of wound infection, intrauterine infection and chest infection was higher in the emergency group and this resulted in an increased proportion of the women requiring antibiotic therapy in the postnatal period. The study found that there was considerable postoperative morbidity associated with Caesarean delivery, particularly if the operation was carried out as an emergency procedure.