Maternal infection rates after cesarean delivery by Pfannenstiel or Joel–Cohen incision: A multicenter surveillance study

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• 作者：Anne Marie Dumas ; Raphaë ; le Girard ; Louis Ayzac ; Emmanuelle Caillat-Vallet ; Franç ; oise Tissot-Guerraz ; Agn&#xe8 ; s Vincent-Bouletreau ; Michel Berl
• 关键词：Joel– ; Cohen technique ; Pfannenstiel technique ; Nosocomial infections ; Endometritis
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：147
• 期：2
• 页码：139-143
• 全文大小：110 K

文摘

Objective

Our purpose was to evaluate maternal nosocomial infection rates according to the incision technique used for caesarean delivery, in a routine surveillance study.

Study design

This was a prospective study of 5123 cesarean deliveries (43.2 % Joel–Cohen, 56.8 % Pfannenstiel incisions) in 35 maternity units (Mater Sud Est network). Data on routine surveillance variables, operative duration, and three additional variables (manual removal of the placenta, uterine exteriorization, and/or cleaning of the parieto-colic gutter) were collected. Multiple logistic regression analysis was used to identify independent risk factors for infection.

Results

The overall nosocomial infection and endometritis rates were higher for the Joel–Cohen than Pfannenstiel incision (4.5 % vs. 3.3 % , 0.8 % vs. 0.3 % , respectively). The higher rate of nosocomial infections with the Joel–Cohen incision was due to a greater proportion of patients presenting risk factors (i.e., emergency delivery, primary cesarean, blood loss ≥800 mL, no manual removal of the placenta and no uterine exteriorization). However, the Joel–Cohen technique was an independent risk factor for endometritis.

Conclusion

The Joel–Cohen technique is faster than the Pfannenstiel technique but is associated with a higher incidence of endometritis.