Sandra Quinn, Project Lead for Surgical Site Infection Surveillance, at the York and Scarborough Teaching Hospitals NHS Foundation Trust, examines the rise in Caesarean births, why Caesarean section SSIs are common, and considers some measures which could help reduce infection rates.
The latest NHS data shows that, in England, 42% of babies were delivered by Caesarean section (CS)1, compared to just 9% in 1980.2 One of the most frequent complications of CS is surgical site infection (SSI); with an estimated incidence of around 16%.3 Post-caesarean SSI potentially extends the period of hospitalisation by four days, and is estimated to cost an additional £3,173 per patient.4 While SSIs are common, they have been described as "the most preventable" healthcare-associated infection,5 and it is estimated that around 60% of SSIs could be prevented.6 Based on reported evidence and guidelines, measures including skin and wound care may be effective in helping prevent infections.
Caesarean section (CS) is one of the most frequently performed surgical procedures and rates are increasing, not just in the UK but across the world.4 Global CS rates have escalated from around 7% in 1990 to 21% in 2021 and are projected to continue increasing over the current decade.7 In some countries, Caesarean births now outnumber vaginal deliveries.7
CS is usually recommended when a vaginal delivery (VD) may pose risks to either the mother, baby, or both. These situations include prolonged or obstructed labour, foetal distress, elevated blood pressure or glucose, multiple pregnancies, or abnormal presentation/position of the baby among others.8 CS, whether undertaken as a planned or an emergency procedure, reduces both maternal and neonatal morbidity and mortality significantly.8
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