An infection that develops after a C-section, known as a post-cesarean wound infection, is typically caused by bacteria affecting the surgical incision area. Common symptoms include a fever ranging from 100.5ºF to 103ºF, tenderness in the wound, swelling, and inflammation at the site, as well as lower abdominal discomfort. Seeking prompt treatment is crucial to avoid potential complications arising from the infection. Let’s take a look at signs of infection after a C-section, how they’re treated and diagnosed, along with some prevention tips.

What Causes Post-Cesarean Wound Infections?

Post-cesarean wound infections are typically caused by dangerous microbes coming into contact with the surgical incision. The most common bacterium responsible for these infections is Staphylococcus aureus, followed by Enterococcus and Escherichia coli, which are normal inhabitants of the skin. Antibiotic medications are commonly used for treating the causes and signs of postpartum infection after a C-section.

There are two main types of infections that can occur: incisional and wound abscesses. 

• Incisional infections affect the site of the wound itself, involving either the skin or the deeper tissues around the incision. An example of an incisional infection is cellulitis. In this condition, the underlying tissue beneath the skin becomes inflamed. The redness and swelling rapidly extend from the surgical incision to the surrounding skin. The infected skin is typically warm and sensitive when touched. Generally, there is no presence of pus within the incision itself.
• A wound abscess is caused by the same bacteria responsible for cellulitis (as well as other types of bacteria) but spreads to surrounding areas and organs, such as the bladder or urinary tract. Redness, tenderness, and swelling along the edges of the incision are all possible signs of internal infection after a C-section. Most wound abscesses release pus from the incision. Abscesses can develop at various sites such as the uterine incision, scar tissue, ovaries, and adjacent tissues or organs in the presence of post-surgical infection. Some of the bacteria causing a wound abscess can also lead to endometritis, an inflammation of the uterine lining after a cesarean section. This condition may manifest with symptoms like pain, abnormal bleeding, discharge, swelling, fever, and general discomfort.

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Who’s at Risk for Post-Cesarean Wound Infections?

Certain factors can increase the likelihood of a woman developing signs of infection after a C-section birth. These risk factors include obesity, diabetes, immunosuppressive disorders (such as HIV), chorioamnionitis during labor, long-term steroid use, inadequate prenatal care, previous cesarean deliveries, lack of preventive antibiotics or antimicrobial care before incision, prolonged labor or surgery, and excessive blood loss during labor, delivery, or surgery.

A study published in the South African Medical Journal in 2012 found that women who receive nylon sutures or staple sutures after cesarean delivery are more prone to developing infections. For this reason, sutures made from polyglycolide (PGA) are preferred since they are absorbable and biodegradable.

What Are the Most Common Symptoms of Infection?

After undergoing a cesarean delivery, it is crucial to closely monitor the appearance of your wound and diligently follow your doctor's postoperative instructions. If you are unable to observe the wound yourself, ask a loved one to check it every other day for any signs of a possible infection. It's important to note that having a cesarean delivery can also increase your risk of other complications, such as blood clots. If you experience any of the following symptoms after being discharged from the hospital, contact your healthcare provider or seek medical attention:

• Severe abdominal pain
• Redness or swelling at the incision site
• Pus discharge from the incision site
• Persistent or worsening pain at the incision site
• Fever exceeding 100.4ºF (38ºC)
• Painful urination
• Foul-smelling vaginal discharge
• Excessive bleeding that saturates a feminine pad within an hour
• Bleeding accompanied by large clots
• Leg pain or swelling

Promptly addressing these symptoms with your healthcare provider can help ensure appropriate medical care and prevent potential complications.

What Should I Do If I Notice Signs of Infection After C-Section Surgery?

Diagnosis

While some post-cesarean wound infections are addressed before a patient is discharged from the hospital, many infections manifest after leaving the hospital. In fact, signs of infection 3 weeks after a C-section are quite common and may be diagnosed during your post-natal follow-up visits.

Diagnosing wound infections involves evaluating the appearance of the wound, monitoring the progress of healing, assessing the presence of common infection symptoms, and identifying specific bacteria. In some cases, the doctor may need to open the wound to accurately diagnose the infection and provide appropriate treatment. If there is pus draining from the incision, the doctor might utilize a needle to remove the pus for further examination in a laboratory to identify the bacteria present.

Treatment

If you develop signs of infection after a C-section birth, taking antibiotics will help it heal. These antibiotics are designed to specifically target staphylococcus and streptococcus. This is typically treated with intravenous antibiotics inside a hospital setting. Patients who aren’t hospitalized are usually given or prescribed antibiotics to be taken at home.

Wound abscesses are also treated using antibiotics and require special attention. Your doctor will carefully open the incision in the infected area to drain the pus. After the area is thoroughly cleansed, the doctor will apply an antiseptic and cover it with gauze to prevent further pus buildup. It's important to regularly monitor the wound to ensure proper healing. After a few days of antibiotic treatment and cleansing, your doctor will examine the incision once again. At this stage, the wound may be closed or left to heal naturally, depending on its progress and condition.

How Do I Prevent Signs of Infection After a C-Section Birth?

While certain surgical site infections may be beyond your control, there are steps you can take to reduce the likelihood of infection after a C-section. If you're considering an elective C-section, you can take preventive measures to avoid complications, such as maintaining a healthy weight, keeping blood sugar levels stable, and not smoking. 

If you’ve already undergone a C-section, here are some measures you can follow to prevent infection:

• Adhere to the wound care instructions and take the prescribed postoperative medication as directed by your doctor or nurse. If you have any questions, don't hesitate to reach out to your healthcare provider.
• If you have been prescribed antibiotics to prevent or treat an infection, you must complete the full course of treatment without skipping doses or stopping prematurely.
• Regularly clean your wound and change the dressings as instructed.
• Avoid wearing tight clothing or applying lotions directly on the wound.
• Seek advice on holding and feeding the baby in a way that minimizes pressure on the wound, especially if you plan to breastfeed.
• Prevent skin folds from covering or touching the incision area.
• If you feel feverish, use an oral thermometer to monitor your temperature. Seek medical attention or contact your doctor if your temperature exceeds 100ºF.
• Seek medical care if the incision site contains pus, swells, becomes increasingly painful, or exhibits spreading redness on the surrounding skin.

It's important to note that women who have vaginal deliveries are generally at a lower risk of postpartum infections. However, in some cases, vaginal birth after a C-section (VBAC) may pose risks to both the mother and the baby. It's crucial to discuss your personal risk factors with your doctor.

What’s the Prognosis for Post-Cesarean Wound Infections?

Early treatment of a post-cesarean infection can lead to a successful recovery with minimal long-term effects. The healing process for a routine incision typically takes four to six weeks, according to the Mayo Clinic. However, if a wound infection is identified before your discharge from the hospital, your hospital stay may be extended by several days. This can also result in increased hospitalization costs.

In cases where a post-cesarean wound infection occurs after you have already been discharged, you may need to be readmitted to receive intravenous medications or undergo further surgical procedures. Some infections can be treated on an outpatient basis with additional doctor visits and the use of antibiotics.

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. Please contact your health provider if you have any medical questions or concerns about your child or yourself.

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