A descriptive cross sectional study of patients who presented with puerperal sepsis at the. Who recommendations on postnatal care of the mother and newborn. Assessment of infection control practices in maternity units. Knowledge of symptoms and signs of puerperal sepsis in a. Puerperal fever most persistent fevers after childbirth are caused by genital tract infection temperature 38. Estimates from hospital sources in nigeria indicate that puerperal sepsis complicates 1. The genital tract may be involved alone or there may be spread to other sites. Lack of evidence supporting hygiene alone hygienic practices were not more likely to prevent postpartum infection other factors which seem to contribute to infection and puerperal sepsis were long and difficult labor cochrane. Puerperal sepsis is defined in the international classification of diseases icd10 as a temperature rise above 38. Introduction historically, puerperal sepsis has been a common pregnancyrelated condition, which could eventually lead to obstetric shock or even death. Jun 28, 2018 there is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in subsaharan africa.
Bacterial infection following childbirth infection of the birth canal after the first 24 hours following delivery of a baby temperature 38o c taken by mouth, 4 times daily occur on any two of the first 10 days. Other postpartum infections include 1 postsurgical wound infections, 2 perineal cellulitis, 3 mastitis, 4 respiratory complications from anesthesia, 5 retained products of conception, 6 urinary tract. The global incidence of puerperal sepsis maureen chisembele. The global maternal sepsis study and awareness campaign. Puerperal sepsis is the second most common cause of maternal mortality in the developing world. Researchers in nigeria have reported that puerperal sepsis accounts for 12% of maternal deaths in nigeria and that till date, little is known about the background hospital factors that predispose pregnant women to puerperal infection that leads to mortality okonofua et al. It is the third most common cause of maternal death worldwide as a result of child birth after haemorrhage and abortion.
Benefit of vaginal chlorhexidine washes is unproven rr. Jan 09, 2018 the who has released a statement on maternal sepsis. In this paper the extent of the problem is described and factors affecting puerperal sepsis are identified. In nigeria, puerperal sepsis accounted for 12% of maternal deaths 7 in ethiopia, puerperal sepsis accounted for about % of all maternal deaths and became one of the top four causes of. Successful intervention strategies in resourcerich settings. Sample registration system srs, india estimated that 16% and 11% maternal deaths in the year 1998 survey of causes of death and 200103special. A puerperal infection is a more general term than puerperal sepsis and includes not only infections due to puerperal sepsis, but also all extragenital infections and incidental infectionswho. If the temperature persists even after 10 days patient with post partum fever can be assumed to have. Nov 16, 2016 a puerperal or postpartum infection occurs when bacteria infect the uterus and surrounding areas after a woman gives birth. Signs and symptoms usually include a fever greater than 38. Global burden of maternal sepsis in the year 2000 carmen dolea 1, claudia stein 1 evidence and information for policy eip, world health organization, geneva, july 2003 1. Pdf puerperal sepsis and its cause in patan hospital.
Risk factors include caesarean section csection, the presence of certain bacteria such as group b streptococcus in the vagina, premature rupture of membranes, multiple vaginal exams, manual removal of the placenta, and prolonged labour among others. One hundred and fortysix patients were diagnosed as having puerperal sepsis and there were 8428 deliveries giving an incidence of 1. The puerperal sepsis pyrexia presents commonly with fever and other symptoms like pelvic pain, foul smelling vaginal discharge and delayed reduction of the uterine size. Postpartum infections comprise a wide range of entities that can occur after vaginal and cesarean delivery or during breastfeeding. The remarkable fact emerges that in england and wales puerperal sepsis is more prevalent, or, at any rate, that it fig il. Puerperal sepsis attributed to home deliveries accounts for 15 per cent of total maternal deaths in kenya.
Puerperal sepsis is a common pregnancy related complication and is one of the leading causes of maternal morbidity and mortality in sub saharan africa. This infection may originate at the placental site or within lacerations of the cervix, vagina, or perineum. The content then covers the factors which contribute to the infection, how it. Impact of puerperal sepsis selfcare nursing guideline on. Puerperal sepsis or postpartum infection refers to the condition of developing bacterial infection in women after childbirth or during breastfeeding.
Maternal deaths relating to sepsis are often associated with failure to recognise the severity of illness. We enrolled 4231 women presenting to a ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and measured. According to world health organization who estimates puerperal sepsis accounts for 15% of the 500000 maternal deaths annually. Maternal mortality at the university of nigeria teaching hospital, enugu. Puerperal sepsis, the leading cause of maternal deaths at a. Mar 05, 2014 puerperal infection is an infection of the genital tract which occurs as a complication of delivery. We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Questions about clinical guidance and actual practice. There is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in subsaharan africa. The departmental policy requires that all patients with puerperal sepsis be placed on broad spectrum antibiotics empirically and the treatment modified. Most of the estimated 75 000 maternal deaths are recorded in lowincome countries.
Puerperal sepsis, the leading cause of maternal deaths at a tertiary. Puerperal sepsis in a rural hospital in sudan ncbi. The primiparouspostnatal mothers who received and compliance with the guidelines regarding puerperal sepsis and its prevention had high knowledge and practices score in the posttest of the intervention program than in pretest p. The mortality from sepsis is hereplottedoutfor thefourquartersoftheyear, over a series of years. The objective of this study is to determine the knowledge of symptoms and signs of puerperal sepsis. There is paucity of regional data on the antibiogram and risk factors associated with this condition,aim. The main causes of the reported high mortality ratio in northern nigeria are haemorrhage, eclampsia, sepsis and unsafe abortion, while the indirect causes include hepatitis, anaesthetic complications, hivaidsrelated deaths and acute renal failure. It usually occurs after the first 24 hours and within the first ten. The longterm morbidity associated with maternal sepsis is significant and includes chronic pelvic inflammatory disease, chronic. We enrolled 4231 women presenting to a ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and. Risk factors and complications of puerperal sepsis at a tertiary. Puerperal sepsis accounts for 110 of the global burden of maternal morbidities and mortalities.
Who recommendations on postnatal care of the mother and. Ppt puerperal sepsis powerpoint presentation free to. Jan 30, 2018 the most widely used definition and identification criteria for sepsis are based on consensus for adult patients. Microbial isolates in puerperal sepsis and their in vitro antibiotic. Improved obstetric care availability of wide antibiotic 8. Ways to prevent puerperal sepsis and reduce maternal. Wed like to understand how you use our websites in order to improve them. In africa and asia, puerperal sepsis is the second commonest cause of maternal. Out of 302 patients with puerperal problems there were 92 patients with puerperal sepsis which makes 30. Puerperal sepsis is infection of the genital tract after delivery or abortion. Puerperal sepsis is the second most common cause of maternal mortality in. It may arise indepen dently or as a consequence of any of the preceding conditions. Methods of reducing the incidence of puerperal sepsis are suggested.
Article information, pdf download for puerperal sepsis. Who recommendations on postnatal care of the mother and newborn grade1 profiles, and analysis of the benefits and risks, values and preferences, and costs of implementation. Even lower rates of puerperal sepsis have been reported in west africa, as low as 0. Use of unclean medical instruments on the private parts and touching the motherread more. Puerperal sepsis with special reference to india springerlink.
The most common infection is that of the uterus and surrounding tissues known as puerperal sepsis, postpartum metritis, or postpartum endometritis. Puerperal sepsis, perineal pain, dyspareunia, postpartum haemorrhage, gestational. Causes of maternal deaths in northern nigeria research cyber. Puerperal sepsis is a leading cause of mortality in developing countries. The abortion complications included postabortion septic shock and hemorrhage and these constituted 10. Demographic details are described in table1, antenatal booking status was 0. Puerperal sepsis infection of the genital tract following child birth.
This paper is based on one originally given at the icmwhounicef precongress workshop in kobe, japan, october, 1990. Postpartum infections, also known as childbed fever and puerperal fever, are any bacterial infections of the female reproductive tract following childbirth or miscarriage. Puerperal infection can also cause longterm reproductive morbidity in women, including secondary infertility 15. Cases of maternal mortality have not declined in spite of efforts by both the public and private sector to prevent such deaths momoh et al. If the temperature persists even after 10 days patient with post partum fever can be assumed to have genital. Original article postpartum practices of parturient women. Existing definitions related to maternal sepsis may be confusing e. This study aimed to investigate the impact of puerperal sepsis selfcare nursing guidelines on womens knowledge and practice among primiparous postnatal mothers. Along with hemorrhage and hypertension, infection remains one of the most common causes of maternal mortality in developing nations see related article practical advice on preventing maternal death due to postpartum hemorrhage on preventing maternal death due to postpartum hemorrhage puerperal sepsis, defined as an infection of the genital tract acquired at the time of delivery or in the. Knowledge of symptoms and signs of puerperal sepsis in a community in northeastern nigeria. Included in the study were patients with puerperal sepsis admitted into ife state hospital of obafemi awolowo university teaching hospital complex in nigeria during the period of january 1986 to. Sepsis, defined as the condition arising when the host response to infection causes organ dysfunction in the host, remains a major killer. Retrospective studies estimate that puerperal sepsis causes approximately 10% of maternal deaths in africa.
Yes improvement in 24 hours no continue iv antibiotics for 3 days. In addition to trauma sustained during the birth process or cesarean procedure, physiologic changes during. In lowincome countries, the mortality related to puerperal sepsis is approximately 33%. Patients with a puerperal genital tract infection are susceptible to the development of. Prevalence, correlates, maternal morbidity, childbirth, nigeria. Puerperal sepsis, an infection of the genital tract following childbirth is among.
American journal of respiratory and critical care medicine. Risk factors and complications of puerperal sepsis at a. Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of methodological limitations. Incidence of postpartum infection, outcomes and associated. The main causes of the reported high mortality ratio in northern nigeria are haemorrhage, eclampsia, sepsis and unsafe abortion, while the indirect causes include hepatitis, anaesthetic complications, hivaidsrelated. Global survey on puerperal infection prevention and management. Puerperal sepsis is an important public health problem which is leading cause of maternal death, especially, in developing countries due to the lack of knowledge on preventive methods. Management of puerperal sepsis sri lanka college of obstetrics and gynaecology health sector development project guidelines management of puerperal sepsis feverpurulent vaginal dischargepelvic pain very sick high fever, altered consciousness, rapid pulseassume critically ill. Puerperal infection is still a significant cause of morbidity and. Puerperal sepsis, the leading cause of maternal deaths at. Specific interventions necessary to prevent and treat infections are. There is marked decline in puerperal infection due to. Pdf puerperal sepsis at usmanu danfodiyo university teaching. A puerperal or postpartum infection occurs when bacteria infect the uterus and surrounding areas after a woman gives birth.
In nigeria, for example, two studies showed an incidence of puerperal sepsis of 1. Thank you for your interest in spreading the word about the bmj. Probably the most often quoted article on the epidemiology of sepsis is the 2001 publication by angus and colleagues, which used administrative data to estimate that there were 751,000 cases 3. Patients with puerperal sepsis following delivery at ife state hospital ish of obafemi awolowo university teaching hospitals complex oauthc ile. Local spread of colonized bacteria is the most common etiology for postpartum infection following vaginal delivery. Who statement on maternal sepsis global sepsis alliance. Maternal and early onset neonatal bacterial sepsis. Endometritis is the most common infection in the postpartum period. Whether the delivery is cesarean or vaginal, if a woman has sustained any trauma she runs a risk of developing puerperal sepsis. In nigeria, puerperal sepsis is the 3rd leading cause of maternal mortality and contributes 12% of maternal mortality 6. A study at ife state hospital in nigeria showed that 31. Puerperal infection morbidity affects 2 10% of patient.
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