PUERPERAL SEPSIS —STILL A MAJOR THREAT FOR PARTURIENT
AbstractBackground: Puerperal sepsis is one of the leading causes of preventable maternal morbidity andmortality. It is still ranked as 3rd major cause of maternal deaths in our country. The objective of thisstudy was to evaluate morbidity and mortality from puerperal sepsis and to identify its risk factors.Methods: This observational study was carried out in Ayub Teaching Hospital over a period of threeyears. All patients admitted with diagnosis of puerperal sepsis secondary to genital tract infection wereevaluated with thorough details of history and examination to determine their demographic details,obstetrical profiles, presenting features, state of infectious morbidity, need for intervention andmortality related to puerperal sepsis. Results: Puerperal sepsis was 1.7% of all obstetrical admissionsand 34.4% of postnatal complications. It was seen common among young patients of 15–25 years age,61 (66.3%), of lower parity, 58 (63.00%), low socioeconomic status, 60 (65.20%), uneducated patients,72 (78.20%), home deliveries, 68 (73.90%), prolong labour, 54 (58.60), prolong rupture of membranesfrom 48–72 hours, 68 (73.8%) and deliveries conducted by untrained birth attendants, 57 (60.5%).Puerperal sepsis morbidity was mostly foul smelling discharge, 23 (25%), retained product ofconception, 41 (44.5%), peritonitis, 8 (8.60%), septicaemia, 4 (4.3%), pelvic abscess, 10 (10.80%),endotoxic shock, 4 (4.30%), disseminated intravascular coagulation, 2 (2.1%). Sepsis related mortalitywas 6/42 (14.2%). Conclusion: Puerperal sepsis is an important public health problem contributing tomaternal morbidity and mortality. Majority of predisposing factors are preventable. Optimal antisepticmeasures and careful monitoring are needed throughout the process of labour.Keywords: Puerperal sepsis, Maternal mortality, Rupture of membranes, Obstructed labour,Traditional birth attendant, TBA, disseminated intravascular coagulation, DIC
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