Introduction

1. Urinary tract infection and wound infection in obese women undergoing cesarean section at Women's Health Center Heba Mostafa ,Sahar Nagieb, Tarel Khalaf, Hamida Alam Eldeen, Faculty of Nursing, Faculty of medicine, Assiut University Egypt Introduction Subjects and Method Results • Research Design • A Prospective study was used in carrying out this study. • Setting • The study was carried out in wards of Obstetrics Department in Women's Health Center at Assiut university hospital. • Inclusion criteria:- • 1- All obese women categories according to the classification of (WHO, 2010) • Class I obesity 30.00 – 34.9 kg/m² • Class II obesity 35.00 - 39.9 kg/m² • Class III obesity ≥ 40.00 kg/m², chosen at any age group at Women's Health Center. • 2- Elective cesarean section. • Diabetic women • Premature rupture of membrane during pregnancy. • Ante partum hemorrhage • Tools • Part I: An interviewing Sheet: • Was designed for this study used to collect the relevant data from group of obese and non obese women admitted to postpartum department which included all women's data • Such as:- Sociodemographic data, maternal and obstetric history, outcomes of previous deliveries, current antenatal conditions, neonatal conditions, post operative (puerperal) complications……etc • Part II: Practical Work: • Measured women's height and weight to calculate the body mass index according to the equation of BMI. • Part III: Laboratory investigations: • Collect the Clean-catch midstream urine sample to the lab for culture. • Infected wound swab was taken if the wound became infected and women re-hospitalized • Part IV: Follow up schedule • Follow up for women was scheduled after one week until one month through the outpatient clinic if the women returned for wound dressing and to ensure that the wound clean or through a telephone call to ensure that the wound was clean or became infected. Obesity is a chronic metabolic disorder caused by an imbalance between the intake of food and the expenditure of energy resulting in an excessive amount of adipose tissue. Obesity is defined as (BMI) ≥ 30 kg/m2 or a person having more than 20 percent of ideal weight. BMI of a person is the key factor to define obesity. Obesity has become an epidemic health problem among pregnant women. In Egypt 70 percent of women are overweight or obese (Asfaw, 2006).The incidence of obesity among pregnant women in the United States of America (USA) ranges from 18.5% to 38.3% . Obese women significantly more infections than women with a normal (BMI). A greater rate of infection associated with obese women undergoing caesarean section (S.C) surgery has been reported. Surgical site infection (SSI) is the second most common infectious complication after urinary tract infections (UTIs) following (S.C) delivery . Surgical site infection (SSIs) is an infection that develops within 30 days after an operation or within one year if an implant was placed and the infection appears to be related to the surgery which occurs in 2%-16% of women depending on many factors such as diabetes, obesity, length of labour, number of vaginal examinations and antibiotics prophylaxis . Urinary tract infection (UTI) is a broad term used to describe bacterial infection or inflammation of the bladder (cystitis), urethra (urethritis), or renal pelvis and kidneys (pyelonephritis) and microbial colonization of the urine. Approximately 10% of women are diagnosed with UTIs in the (USA) yearly more than men because ascending infection from urethral opening and vagina to the perineal area. Approximately 10% of women are diagnosed with UTIs in the (USA) yearly more than men because ascending infection from urethral opening and vagina to the perineal area. Recommendations Obesity is epidemic health problems, the antenatal healthcare systems, obstetricians and midwives will be forced to deal with the problems related to obesity. Implementation a standard of care and infection control strategies in preoperative, intraoperative and mainly post operative periods would serve to improve prevention and identification of post pregnancy infections in women and reduce the associated burden of morbidity and mortality on the lives of women and their families. Implementation a standard of care and infection control strategies in preoperative, intraoperative and mainly post operative periods would serve to improve prevention and identification of post pregnancy infections in women and reduce the associated burden of morbidity and mortality on the lives of women and their families. Directed patient education regarding risk factors and symptoms of postpartum infection must be included as part of comprehensive, quality follow-up care of women postpartum. Nurses should be encouraged to attend specific meetings as workshops and seminars held for urinary tract infection prevention to be acquainted with the most recent advances and skills in this area. Conclusions The incidences of urinary tract infections are significantly higher in obese women (22.8%) rather than non obese women (12.4%), and the most common causative organism is Klebsiella then Escherichia Coli and also the incidences of surgical site infections are significantly higher in obese women (12.4%) compared to non obese women (3.2%). References Aims of the study National Health Institute, 2007. Mercola, 2006. Reilly, et al, 2006. Pasulka, et al, 2000. Henry Rhee and Bonnie Harris, 2008. Marliyn, 2008. Estimate the incidence of urinary tract infection and wound infection post cesarean section in obese women and compare between two groups of obese and non-obese women. Estimate the most causative organisms of urinary tract infection and wound infection