The Incidence and Associated Factors of Perineal Wound Infection Following Vaginal Delivery in Charoenkrung Pracharak Hospital, Bangkok, Thailand

Abstract

Objectives: To measure the incidence and assess the associated factors for perineal wound infection and dehiscence following vaginal delivery.
Materials and Methods: This retrospective study was conducted between October 2018 and September 2020 in Charoenkrung Pracharak Hospital. The incidence of perineal wound infection and dehiscence was calculated. There were 4,015 delivered vaginally. A total of 2,589 pregnant women were enrolled. The data collection tools included postpartum ward daybook, electronic patient records, and clinical data of perineal wound examination at first 72 hours after delivered was reviewed. The association factors were analyzed by logistic regression.
Results: The incidence of perineal wound morbidity was 2.9% (1.7% of wound infection and 1.2% of wound dehiscence). Gestational hypertension (adjusted odds ratio (aOR) 3.77, 95% confidence interval (CI) 1.28-11.12), number of vaginal examinations > 4 (aOR 4.21, 95%CI 2.29-7.73), neonatal birth weight ≥ 3 kg (aOR 4.28, 95%CI 1.89-9.7) and registered nurse with less than 5 years of experience (cOR 3.04, 95 % CI 1.46-6.35) increased the risk of wound infection. Prophylactic antibiotic reduced the risk of perineal wound infection (aOR 0.29, 95%CI 0.1-0.82). There was no significantly associated risk factor for perineal wound dehiscence.
Conclusion: Perineal wound morbidity was found to be 2.9% with 1.7% of perineal infection and 1.2% of perineal dehiscence. The number of vaginal examinations > 4, neonatal birth weight ≥ 3,000 grams, gestational hypertension, and healthcare providers with experience < 5 years increased the risk of perineal wound infection. Prophylactic antibiotics reduced the incidence of infected perineal wounds.