The relationship of hospital-acquired infection to invasive intrapartum monitoring techniques.

A 6 month survey of hospital-acquired uterine infection was done on the obstetric service of the Los Angeles County-University of Southern California (LAS-USC) Medical Center to determine the impact of the duration of monitoring upon the incidence of maternal infection. There were significantly more infections among the population monitored and in women undergoing cesarean section. In diminishing order, the incidence of infection was: cesarean section monitored, 90 of 223 (40.4 per cent); cesarean section not monitored, 56 of 271 (20.4 per cent); elective repeat cesarean section, 1 of 21 (5 per cent); vaginal delivery monitored, 33 of 1,236 (2.7 per cent); and vaginal delivery not monitored, 49 of 3,445 (1.4 per cent). In comparing those patients with infection and those free of infection following equivalent routes of delivery, there was no statistical difference in the duration of monitoring. These results suggest that the interval of monitoring alone is not a significant clinical factor in the development of maternal soft-tissue pelvic infection in a high-risk obstetric population.