Postpartum Case Series of Abdominal/Pelvic Abscess in Nizwa Hospital: A Rare Event with Review of Literature

Abstract

Introduction: Intra-abdominal infection (IAI) is a pocket of pus or infected fluid located within the abdominal cavity. IAI is recognized as a major contributor to mortality worldwide if not well managed. Infections can occur within the pelvis, around the operation site, or in the organs. These infections lead to serious complications, lengthen hospital stays, increase medical costs, and can increase maternal morbidity and mortality. Aims /Objectives of the Study: Mitigating complications from surgical site infection, medical cost containment, ameliorate patient’s outcome and highlight universal standards of care and management. Study Design: Retrospective study of postpartum cases who suffered abdominal /pelvic abscess formation In Nizwa hospital, Oman. Data was collected from the Alshifa computerized electronic system. Place and Duration: Department of Obstetrics and Gynecology and Department of Radiology, Nizwa Hospital -a two-year study. Methodology: We included 6 cases of postpartum abdominal /pelvic infection during a two-year period from 2022 to 2024. Studied their unusual course of illness with diagnostic and treatment modalities duration their stay in Nizwa secondary care hospital, Oman. Results: The total number of deliveries from 2022 to 2024 were 16,424 Caesarean deliveries accounted to 5045 accounting to 30.71%. Abdominal/pelvic infections were noted in 6 cases in the postpartum period, with severe complications requiring various interventions resulting in intricate prolonged course in high dependency/intensive care units, ultrasound guided drainage of pus or surgical re-exploration and few had to be referred to higher center for management. The infection rate was 0.6/1000, in comparison with the worldwide which is 1/1000. Conclusion: Although the rate of infection is less than the standard, measures to reduce the morbidity and mortality were taken like identifying the root cause, improving the aseptic technique, and a multidisciplinary approach.