Post Caesarean section infective morbidity in HIV-positive women at a tertiary training hospital in Zimbabwe.

OBJECTIVE

To investigate the infective morbidity in HIV-positive and HIV-negative women whose babies were delivered by Caesarean section.

DESIGN

A hospital based, prospective study: part of a larger operational research project.

SETTING

Harare Maternity Hospital, a tertiary referral teaching hospital in Harare, Zimbabwe.

SUBJECT: 164 HIV-positive and 382 HIV-negative women who were delivered of their babies by Caesarean sections.

MAIN OUTCOME MEASURES: Minor and major infective complications.

RESULTS

The results compare HIV-positive and HIV-negative women, 18/164 (10.9%) HIV-positive women developed anaemia requiring blood transfusion compared with 15/382 (3.9%) HIV-negative women. The difference was statistically significant (RR 3.05). HIV-positive women had a statistically significant increase in the incidence of post operative fever (RR 1.3) and wound sepsis/sinus (p = 0.002).

CONCLUSION

Our study indicates that HIV-positive women who were given prophylactic pre-operative antibiotics were at an increased risk of minor infective complications and blood transfusion post Caesarean section. The risk of blood transfusion was higher in women who had a pre-operative haemoglobin of 10.5 grams/dl. Post operative fever, wound sepsis and wound sinus was commoner in HIV-positive when compared to HIV-negative women.