THE FREQUENCY OF GLOVE CONTAMINATION DURING CESAREAN DELIVERY

Objective: To determine the frequency of glove contamination associate d with fetal extraction during cesarean delivery. Methods: The study w as performed in 25 women having scheduled or unscheduled cesarean deli very. Surgeons double-gloved for all procedures. Immediately before an d after delivery of the fetus, the dorsal aspect of the fingers an han d of the surgeon's outer glove was swabbed with cotton tip applicators and cultured for aerobic and anaerobic organ isms. Only the glove fro m the hand that was used to deliver the infant was cultured. Results: Nine of 25 cultures (36%, 95% confidence interval [CI] 17-55) performe d immediately before fetal extraction were positive for staphylococci. No other organisms were isolated. Cultures performed following fetal extraction showed non-staphylococcal bacteria in 11 of 14 (79%, 95% CI 58-100) laboring women and one of 11 (9%, 95% CI 0-26) nonlaboring wo men, a statistically significant difference (P < .01). In the laboring patients, non-staphylococcal bacteria were isolated with similar freq uency from the dorsal aspect of the hand (seven of 14, 50%, 95% CI 24- 76) and the fingers (ten of 14, 71%, 95% CI 47-95). These cultures yie lded mostly bacterial species from the Enterobacteriaceae family. Conc lusion: In laboring patients with ruptured membranes, delivery of the fetal head frequently results in contamination of the surgeon's glove with pathogenic bacteria. This finding may partially explain the incre ased frequency of post-cesarean endometritis associated with manual ex traction of the placenta.