Researchers in the Department of Obstetrics and Gynecology are asking an old question in a new population: Can giving extra oxygen to a patient undergoing a Caesarean section (C-section) decrease the risk of serious postoperative infection?
In past studies, colorectal surgery patients given supplemental oxygen had fewer infections after surgery, supporting the theory that increasing oxygen in the tissue at the incision site will help suppress developing bacteria.
Fifteen percent to 20 percent of women having unscheduled C-sections and 5 percent to 10 percent of women undergoing elective C-sections develop an infection in the uterus.
Abdominal wound infections also occur in 5 percent of women having C-sections.
Christina Scifres, M.D., a fellow in maternal/fetal medicine, developed the idea for this study after treating many patients who got infections after C-sections. These women typically have to stay in the hospital a few days longer or be readmitted, she said. Often, they have to undergo or perform serial wound packing (with gauze dressings) at home and attend extra doctor’s visits. They also may have more trouble breastfeeding.
“I wanted to see if this approach could also work in this pregnant patient population,” Scifres said. “It’s an inexpensive and easy solution that we hope will help.”
Scifres is conducting the study with David Stamilio, M.D., associate professor of obstetrics and gynecology and the study’s principal investigator.
In this study, eligible pregnant women at Barnes-Jewish Hospital will either be assigned to the oxygen-treatment arm or a “standard-care” arm. Patients in the oxygen arm will receive 80 percent oxygen through a mask during their C-section and for two hours after surgery. Women in the standard care arm will receive about 30 percent oxygen only during their surgery.
Patients will have daily examinations of their surgical wounds while they are in the hospital. They also will be evaluated at their two-week postoperative visit or during a phone call if they’re being treated at outside clinics.
“If this approach works, we could reduce serious complications after surgery and improve quality of life for patients,” Scifres said. “This simple therapy could have a huge impact — each year more than 30 percent of women in the United States require a Caesarean delivery.”