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Identifying Infections After
Cesarean Sections

Dealing with infections after cesarean sections is serious business. Learning the signs and causes can help you know when it's time to call the doctor, or head directly to the ER.

Remember, you've just been through major abdominal surgery. An infection here is not a hang-nail inconvenience.

It is a serious situation that could require months (or even years) of recovery.

Fortunately, only 1 or 2 of every 20 cesareans develops an infection.

The most common places for infections after cesarean sections are in and around the uterus, the urinary tract, and the incision itself.


Before We Dive In and Look Around...

...I have to throw in my disclaimer. I'm not a doctor. I'm not a nurse. I consulted doctors and nurses in writing this article (having them edit and look over everything). I also consulted several medical books as research resources.

When it comes to health issues, the Essential Infant Resource mantra is this:

When in doubt, give your Doc a shout!

If you're not sure of something, give your doctor a phone call. He's the expert who can help you make a definitive decision on what to do. This article is just for information's sake. It's not an attempt to diagnose or treat you

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The following medical portion was reviewed and approved by Dr. Douglas Gaither, MD FACEP.

Identifying Infections After Cesarean

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Signs of an External Infection

External infections of the incision can happen as a result of an allergic reaction to the adhesive tape used in surgery. It will itch like crazy This isn't always a sign of an infection. The itching feeling comes from the nerve endings beginning to re-attach and heal.

Sometimes the strong adhesive tape can remove a layer of skin, opening the door for bacteria to colonize, multiply, and invade, so your incision may feel very tender and raw. An allergic reaction plus removing a layer of skin increases your chances of infection, where antibiotics may be necessary.

At first the wound may itch, but tenderness and drainage could be the first signs of infection. Keep the area clean and dry to prevent an external infection and call your doctor if you have increased redness, swelling, heat or pain.

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Signs of an Internal Infection

Internal infections are a whole other matter, and extremely dangerous. Here are some warning signs of an internal infection:
  • A strong foul-smelling odor around the wound.
  • A lot of discharge out of the wound: lime green, pink, brown, any color should be seen by a doctor. (a little discharge at the beginning is normal.)
  • A temperature of 100.5 or more for longer than 4 hours.
  • If the incision progressively seems puffy, red, and more painful to touch.
  • If your lower abdomen seems to be more hard and firm.
  • If you develop flu-like symptoms.
Although it isn't a sign you have an infection, if your incision splits open see a doctor right away. An open and untreated wound could lead to infection.

A split incision may also be a sign that you are not taking your recovery slow enough. Know your limits at home and avoid a return trip to the hospital.

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Down to the Infection Nitty Gritty

If you don't feel your physician is addressing your possible infection, you may request a consultation with an Infectious Disease Specialist. He will take additional blood work and cultures to accurate diagnose if any bacteria is at work.

If you feel you have an infection and have some of the symptoms above, do not rest until you receive treatment. Even if your doctor says it is normal, seek a second opinion about your condition.

An infection left unattended and uncared for can have disastrous results: loss of feeling, loss of fertility, and sometimes (in severe cases) loss of life. Find answers. Get treated.


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Type of Infections After Cesarean

There are several types of infections after cesarean sections. Nothing is perfect in this world - including hospitals. Although accredited hospitals and surgical centers have (or should-have) strict infection guidelines, bacteria can still spread.

Three common bacterial infections acquired by women hospitalized for cesarean sections include:

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Natural Bacteria on Your Skin (Stephlococcus is the Most Common)

Cellulitis results when the normal skin bacteria invades the tissue layers under the skin (i.e. what the doctor just cut through to deliver your baby).

Bacteria spreading from the uterus to adjacent organs may result in these organs forming scar-tissue connections with your reproductive organs, which may lead to infertility.

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Psuedomonas

Another potentially hurtful bacteria that could find its way to your wound during surgery is hospital-acquired Psuedomonas. It is often resistant to singular antibiotics, so is usually treated with two or more at a time. It often causes a greenish discharge. In more serious cases, surgery has to be done to remove the infected area.

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E-Coli

E-coli is the most natural bacteria in your body. However, antibiotic-resistant strains have developed in the hospital that you can contract during surgery. Your doctor will know best how to treat this more-resistant bacteria. If you show signs of diarrhea or other flu-like symptoms after surgery, see your doctor.

Treatment for Infections After Cesarean

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Treating an External Infection

An external infection is easily treated. After discussing it with your doctor, (and receiving her permission) try laying on your back and pouring hydrogen peroxide sterile normal saline (available at any drug store) over the closed incision. Let it air dry, or use a blow-dryer or soft towel to blot dry. (Do not rub - will hurt!)

Keep the incision as dry as possible. Sweating and wetness will encourage an infection. If the infection doesn't seem to improve, your doctor may prescribe some antibiotics or an antimicrobial wash and cream.

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Treating an Internal Infection

The first thing your doctor will probably do after an infection diagnosis is get you on antibiotics. The more serious the infection, the stronger the antibiotics; perhaps through an IV.

He (or you) may request further testing (like an X-ray, CT, or MRI) of the area to be sure that a sponge or other foreign object was not accidentally left behind after surgery. This is extremely serious, since your body will not be able to break down the object on its own. You will need to be opened up and the item manually removed.

A Wound Vac is another tool doctors use to help remove infection from a wound. It keeps the area clean and viable until it can be reclosed. A Wound Care Specialist can provide another opinion for treatment on your infection.

Worst case scenario, you may need reconstructive surgery to cut away diseased flesh and reattach the healthy tissue to healthy tissue.


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Infections after cesarean sections can often be prevented by keeping the incision clean, dry, and exposed to the air as much as possible during those first few weeks.

If you experience progressive surgical-area redness, swelling, heat or pain, visit your doctor for evaluation and possible antibiotic treatment.

Research Sources

    Complete Book of Pregnancy, and Baby's First Year, Mayo Clinic.

    Complete Book of Baby and Child Care, Focus on the Family

    Caring for Your Baby and Young Child: Birth to Age 5, The American Academy of Pediatrics

    Beyond Birth, Wheaton Franciscan Healthcare


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