C-Section Scar Wound Infection

A C-section scar infection may occur in 3-15% of women who deliver through a C-section. The number of women giving birth through C-sections has increased significantly in the past few decades (1). A prompt diagnosis and management of C-section scar infection can help improve its prognosis and prevent complications.

Read this post to learn more about the causes, signs, diagnosis, treatment, and prevention of C-section scar infection.

What Is A C-Section Wound Infection?

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A c-section wound infection, also known as post-cesarean section wound infection, is a bacterial infection that develops after cesarean  delivery. It is due to bacterial infecting the surgical site (2).The infection could usually happen due to numerous types of bacteria and may be a superficial skin infection or a more dangerous deeper pelvic wound abscess. It is essential to be seen by a doctor as soon as possible to diagnose and treat the problem

What Are The Causes Of Infection After Cesarean Birth?

The following are risk factors for a wound infection (3) (4) (5):

• Obesity
• Increased weight
• Previous cesarean delivery
• Diabetes
• An infection called intraamniotic infection that developed during labor
• Prolonged rupture of membranes
• Repeated vaginal examinations
• An emergency Cesarean delivery

Quick fact

Tobacco use, insufficient or limited prenatal care, twin pregnancy, the prolonged second stage of labor, and excessive blood loss are some other risk factors for infections after a cesarean section (5).

What Are The Signs Of A Post-Cesarean Wound Infection?

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The following are a few symptoms of an infection after c-section.

1. Fever and possible chills typically  with a temperature higher than 100.4 F can be one of the symptoms of a c-section infection. Swelling, redness, or increased pain around the incision or surgical site. Any fluid coming out from the incision, an opening of the incision, and malodorous vaginal discharge are also c-section infection symptoms (6).

2. Discomfort or pain in the lower abdomen region for several days after the surgery.

3. Heavy bleeding and difficulty while urinating are also signs of a c-section infection. In addition to this, you could experience pain and a burning sensation while urinating, and blood in the urine if you have developed an infection (7).

If you have noticed any of these symptoms, consult your doctor for a proper diagnosis.

How Is A Post-Cesarean Wound Infection Diagnosed?

The doctor would check for tenderness, fever, swelling, or any other sign that could indicate an infection. Daily inspection of the incision site is the most vital part of the postoperative diagnosis. However, most of the infections start to appear after a week of surgery. Therefore, doctors advice new mothers to be attentive to these signs. If you see the symptoms, visit the doctor for further diagnosis and timely treatment (8).

How To Treat A Wound Infection?

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A c-section infection can be treated using (5):

1. Antibiotics: Doctors usually recommend treating cesarean wound infections such as cellulitis with antibiotics. If caught early, oral antibiotics are used, however for more advanced cases, intravenous antibioticsⁱXAntibiotics administered into a vein via an injection or catheter to treat or prevent bacterial infections may be necessary.

2. Drainage: For cases where there is a pocket of abscess or pus, opening the skin incision to allow drainage of the infection may be warranted.

Faith Womack, a mother of two from the USA shares her experience of getting infection after cesarean birth. She says, “A month after birth, my C-section wound became infected. My whole abdomen became red, inflamed, and bloated and I was in a lot of pain.

“Finally my husband got me an appointment with my doctor and the doctors told me, ‘Yes, you’re infected.’ She drew the line around the infection and it was just 2 inches above my incision. She prescribed me some antibiotics and told me to come back after a week. But it got worse in two days. I was in so much pain that I can barely breastfeed my child. So I went to the obstetrics clinic again and my doctor told me that I’ll have surgery today.” She later had surgery (i).

3. Dressing the wound: Some infection conditions may require dressing the wound regularly to close the wound and promote healing.

The treatment can be effective and your recovery faster when you follow a few tips.

How to take care of a C-Section Infection Wound?

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Here are some things that you need to take care of.

• Take and complete the antibiotics.

• Go for regular cleaning and dressing of the wound as directed.

• Avoid applying any lotions or creams that may contain chemicals harmful to your skin. And wear loose and lightweight clothes that don’t rub on your wounds.

• You can always get postpartum medical care from your doctor if the wound doesn’t seem to heal or if you experience more pain at the surgical site.

• Consume healthy food and lots of liquids.

Quick tip

If the doctor has applied tape on your incision, let it fall down on its own. It may take about a week (16).

C-Section Scar Healing Stages

The following are the three different stages for a C-section scar to heal:

1. Inflammatory Stage: The initial stage, known as the inflammatory phase, usually lasts a few days following a c-section. This is the point at which the bleeding stops and the body sends white blood cells to the site of the wound to prevent infection. You may notice some swelling and a reddish or pinkish color at the incision site during this phase. Keep an eye out for any signs of infection.
2. Proliferative Stage: At this stage, fibroblast cells gather and multiply at the site of the incision. These cells perform an important role in strengthening the incision site and bringing its edges closer together by making collagen. As this occurs, the c-section scar gets thicker and as it contracts, the color changes. The phase lasts for about three to four weeks.
3. Remodeling Stage: At this stage, the once dense and puffy scar tissue progressively flattens and loses its color. This is the time when the c-section scar is expected to diminish and improve in appearance. The stage may last for months to years (9).

Can You Prevent C-Section Wound Infection?

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You may not be able to entirely prevent the infection after a c-section , but you can take certain precautions to avoid any complications.

1. Maintain a healthy weight: Obesity is one of the risk factors of a c-section wound infection (3). Hence, pregnant women should try maintaining their weight during pregnancy by exercising or consuming a healthy diet.

2. Control diabetes: Gestational diabetesⁱXA condition where the pregnancy's hormonal and physical changes interfere with the body's use of insulin, causing an elevated blood sugar could cause more complications related to the infection after a c-section (10). Therefore, pregnant women should try keeping their glucose levels in check.

3. Treat other conditions/diseases: If you are suffering from any disease/illness or have any pre-existing conditions that may trigger complications with a c-section infection, try to treat them before the due date.

Infographic: Infection After C-Section: Additional Risk Factors And Complications

Although C-section has become a common surgical mode of delivery, post-surgery healing is not easy as you could be exposed to infections in the incisional region. Here is an infographic with the possible risk factors and complications following an infection after C-section.

Illustration: Momjunction Design Team

Learn about post-cesarean infection and antibiotic prophylaxis in this informative video. Understand the risks and how to prevent them with the right treatment.

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Dr. Christian PopeDO, FACOG

Dr. Christian Pope is Board-certified in Obstetrics & Gynecology, and a Fellow of the American Academy of Obstetricians and Gynecologists. He is a long-standing medical staff member and past chairman of Obstetrics and Gynecology at St. Luke's Hospital of SouthCoast Hospitals in New Bedford, Massachusetts and is in private group practice at Hawthorn Medical Associates, Inc. He is a member...more

Ghazia ShahMSc, MA, BEd

Ghazia is a scientist-turned-writer with three years of research experience in Cancer Biology. She did her masters degree in Biotechnology at the University of Kashmir and bachelors in Education at the same university. Ghazia then delved deeper into the science of language with a masters in English. With a Functional English certificate from Indira Gandhi National Open University (IGNOU), she...more

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her post graduation in Biotechnology from MITS School of Biotechnology,...more