Is Perioperative Hypothermia a Risk Factor for Post-CesareanInfection?

[摘要] Objective:To determine whether hypothermia during Cesarean delivery is a risk factor for postoperativeinfection.Methods:An historical cohort investigation was conducted on all women delivered by Cesarean at our centerduring 2001. Initial recovery-room temperature, taken via the oral or axillary route, was used as a surrogatefor intraoperative temperature. Adding 0.5C°to axillary temperatures generated oral temperature equivalents.Women with chorioamnionitis were excluded, as were those with an initial recovery-room temperature thatexceeded 37.9C°or was recorded more than 20 minutes after the end of surgery. Prophylactic antibiotics(cefazolin, 1 g) were given during Cesarean delivery.Results:A total of 42 women (7.6%) were diagnosed with postoperative infections. Infections includedendometritis (n= 25), wound abscess (n= 7), wound cellulitis (n= 7) and urinary tract infection (UTI) (n= 4).No cases of septic pelvic thrombophlebitis or pelvic abscess occurred. One woman had both endometritis and aUTI. Mean temperatures were higher, rather than lower, for women who subsequently had postoperativeinfections compared with those who did not (36.4 ± 0.8C°vs. 35.9 ± 0.7C°;p< 0.001). Mean temperaturesfor the various postoperative infections were as follows: endometritis, 36.5 ± 0.8C°(p< 0.001 vs. uninfectedgroup); wound abscess 36.0 ± 0.8C°(p= 0.63); wound cellulitis, 36.3 ± 0.6C°(p= 0.14); UTI, 36.7 ± 0.9C°(p= 0.04).Conclusions:Women who develop post-Cesarean infections have higher initial recovery-room temperaturesthan those who do not develop such infections. This suggests the presence of subclinical infection at the timeof Cesarean. Evaluating whether intraoperative warming has any role during Cesarean delivery requires arandomized clinical trial.

[学科分类] 妇产科学