Post Caesarean section infective morbidity in HIV-positive women at a tertiary training hospital in Zimbabwe.

OBJECTIVE To investigate the infective morbidity in HIV-positive and HIV-negative women whose babies were delivered by Caesarean section. DESIGN A hospital based, prospective study: part of a larger operational research project. SETTING Harare Maternity Hospital, a tertiary referral teaching hospital in Harare, Zimbabwe. SUBJECT 164 HIV-positive and 382 HIV-negative women who were delivered of their babies by Caesarean sections. MAIN OUTCOME MEASURES Minor and major infective complications. RESULTS The results compare HIV-positive and HIV-negative women, 18/164 (10.9%) HIV-positive women developed anaemia requiring blood transfusion compared with 15/382 (3.9%) HIV-negative women. The difference was statistically significant (RR 3.05). HIV-positive women had a statistically significant increase in the incidence of post operative fever (RR 1.3) and wound sepsis/sinus (p = 0.002). CONCLUSION Our study indicates that HIV-positive women who were given prophylactic pre-operative antibiotics were at an increased risk of minor infective complications and blood transfusion post Caesarean section. The risk of blood transfusion was higher in women who had a pre-operative haemoglobin of 10.5 grams/dl. Post operative fever, wound sepsis and wound sinus was commoner in HIV-positive when compared to HIV-negative women.