MRRHMedical Risk Related History
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All women presenting to the MRRH maternity ward for delivery were approached for inclusion.
The current routine practice at MRRH for women in labor is to clean the vulva using chlorhexidine prior to digital vaginal examination and to give women undergoing Cesarean delivery a single dose of preoperative antibiotics (usually one gram of intravenous ampicillin) within 30 minutes of skin incision.
Since it is standard practice at MRRH for women in labor to have vaginal cleansing with chlorhexidine before any pelvic procedure is done, potential pathogens present in the vaginal canal may have been reduced or eliminated by chlorhexidine, preventing adverse outcomes in these women.
We found a low prevalence (5%) of vaginal GBS colonization in our study population, lower than estimates from other resource-limited settings, ranging from 8 to 31% [25-27], including a prior study at MRRH among pregnant nonlaboring women which demonstrated 29% combined vaginal/rectal GBS colonization [26].
In 2012, major emergency operations contributed more than 43% of the total surgical operations in MRRH (theater records, 2012).
To remedy this lack of data, this study used standardized documentation to provide data of the microbiological etiology, incidence, and riskfactors associated with SSI among patients who underwent emergency operations in MRRH and would be used to establish the sensitivity patterns of organisms to commonly available antibiotics.
Study population was all patients admitted to Mbarara Regional Referral Hospital and underwent emergency surgery and those who had previous emergency surgery at MRRH and were readmitted with wound sepsis within 30 days after operation.
The study was approved by Obstetrics and Gynecology Department, MRRH; Faculty Research Ethical Committee; the Research Ethics Committee of MUST; and Uganda National Council of Science and Technology, and a Material Transfer Agreement was obtained for the work performed at the Massachusetts General Hospital.