Risk Factors and Management of Severe Uterine Incision Infection With Pelvic Abscess Following Cesarean Section

Background: Cesarean section (CS) is a key obstetric surgery, postoperative wound, uterine incision, and pelvic infections are relatively common, so clinicians must pay close attention to the prevention and early detection of surgical site infections. To investigate the risk factors and management strategies for severe uterine incision infections with pelvic abscesses following CS. Methods: We conducted a retrospective study of CS cases performed at our hospital from January 2018 to December 2023. The observation group included 27 patients who developed severe uterine incision infections and pelvic abscesses postoperatively. Each case was matched with 3 controls (total number = 108) who did not develop these complications, selected from the same source population during the study period. Results: Univariate logistic regression analysis demonstrated a statistically significant difference in the incidence of chorioamnionitis, premature rupture of membranes, and preterm delivery between the two groups (p < 0.05). Multivariate stepwise logistic regression further identified preterm delivery (odds ratio [OR] = 4.084, 95% confidence interval [CI] = 1.261–13.224) and chorioamnionitis (OR = 4.388, 95% CI = 1.370–14.058) as independent risk factors for severe pelvic abscess. Conclusion: Chorioamnionitis and preterm delivery are independent risk factors for severe uterine incision infection with pelvic abscess following CS, underscoring the need for heightened perioperative vigilance and targeted preventive strategies in at-risk patients.