The problem of the risk of development of infection of surgical obstetric wound after cesarian section in women of the Kirov region.

Abstract

Over the past decade, the frequency of abdominal delivery in Russia has increased to an average of 25 %. The widespread use of abdominal delivery has not been without an increase in the incidence of complications. Among them is an infectious complication of a surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after a caesarean section, which in some regions reaches 43 %. The development of complications is facilitated by various clinical and laboratory risk factors, the analysis of which in women of the Kirov region is the subject of this article. The analysis of clinical and laboratory risk factors was carried out on the basis of the data presented in the case histories of women hospitalized in the gynecological departments of the city of Kirov. Statistical data processing was carried out on a personal computer using the R-4.0.2 statistical program and Excel spreadsheets. When assessing the relevance of the problem for the Kirov region, it was found that the frequency of caesarean section over the past 10 years from 2011 to 2021 increased from 27,0 % to 34,0 %. The incidence of infectious complications in the Kirov region can be presented as follows: infection of the surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after caesarean section - 27,0 %; peritonitis after caesarean section - 0,94 %-1,01 %; diffuse sepsis - 0,93 %-0,97 %. An important role, according to reports, in the addition of an infection of a surgical obstetric wound after cesarean section is played by the general morbidity and obstetric history in women with abdominal delivery, a detailed statistical analysis of which is presented in the materials of the article. The results of the study substantiated the problem of the development of an infection of a surgical obstetric wound after a caesarean section for the healthcare of the Kirov region, comparable to that for the healthcare of the entire Russian Federation. The analysis of clinical and laboratory risk factors showed the feasibility of using a comprehensive analysis of infection of a surgical wound after cesarean section at an early stage of its development to quickly resolve complications, reduce the duration of hospitalization of women after cesarean section, and subsequently preserve the reproductive function of a woman.