Risk Factors for Peripartum Wound Dehiscence

Abstract

Introduction: Wound Dehiscence (WD) following Vaginal Delivery (VD) or Cesarean Delivery (CD) causes considerable discomfort to the woman, leading to significant physical, emotional and financial burden. The rate of Perineal Wound Dehiscence (PWD) is relatively low and more common with instrumental delivery. However, there is minimal information on the incidence and risk factors causing WD, especially for PWD. Aim: To assess the incidence and risk factors of peripartum wound dehiscence. Materials and Methods: This retrospective study was conducted in a large tertiary care centre where there were 14759 deliveries. 4671 women had caesarean deliveries and 10,088 women had the vaginal delivery. There were 86 cases (0.8%) of WD in the VD group and 95 (2%) in the CD group. These cases were compared with twice as many controls. Results: Induction of Labour (IOL) and BMI >30 kg/m2 were more common in cases compared to controls in the CD group. However, on multivariate analysis, this association was not seen. IOL, meconium stained liquor (MSAF), instrumental delivery and use of episiotomy was more common among cases than controls in the VD group. IOL did not show up as an independent risk factor on multivariate analysis. Conclusion: An association between IOL, primigravidae, instrumental delivery and MSAF was seen with peripartum WD.

Keywords

• episiotomy
• induction of labour
• instrumental delivery
• obesity
• surgical site infection