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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Obstetric Quality and Safety

Poster Session 1

(388) Quality Improvement Initiative to Reduce Wound Complications from Cesarean Delivery in Class III Obesity

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  
Objective:
This study was undertaken to evaluate the impact of a quality improvement (QI) initiative on perioperative wound related complications after cesarean delivery (CD) in patients with a BMI ≥ 40kg/m2.

Study Design:
We evaluated QI process measures and perioperative wound-related clinical outcomes across 2 groups – patients with a BMI ≥ 40kg/m2 undergoing CD before (10/2023 – 9/2024) and after (10/2024 – 6/2025) implementation of a QI initiative centered on prophylactic administration of oral cephalexin and metronidazole in the 48-hour postoperative period.  Primary clinical outcomes included: rates of surgical site infection, triage visit for wound-related problems, wound separation, readmission to the hospital, and need for antibiotic treatment. Process measures evaluated were appropriate antibiotic choice, adherence to recommended regimen, receipt of full course of antibiotics, and reasons for protocol deviations. Continuous and categorical data were compared using Student’s t test and chi squared or Fisher’s exact test, respectively.

Results:
Of the 1334 CDs over the study period, 344 (25.7%) had a BMI ≥ 40kg/m2, of which 275 (20.6%) met inclusion criteria - including 168 in the pre and 107 in the post-implementation group. The overall BMI was 49.36±7.93 kg/m2 Pertinent pregnancy complications, type of CD, and rates of preoperative antibiotic use were similar in both groups, with a significantly higher rate of repeat CDs in the post group. (50.60% vs 64.49%, p= 0.02). Clinical outcomes, including– wound infection [14(8.33%) vs 1(0.93%), p=0.01], triage visits for wound complications [16(9.52%) vs 2(1.87%), p=0.01] and need for antibiotic treatment [13(7.74%) vs 1(0.93%), p< 0.01] were significantly lower in the post- compared to pre-implementation group. Of the 107 patients in the post group, 90 (84.11%) had an order for antibiotics, 74 (82.22%) had the appropriate order, and 63 (85.14%) received the full 48-hour course.

Conclusion:

Prophylactic postoperative antibiotics  have  the potential to significantly decrease wound related complications among patients with class III obesity undergoing CD.