PUERPERAL SEPSIS -STILL A MAJOR THREAT FOR PARTURIENT
Abstract
Background: 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 this
study 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 three
years. All patients admitted with diagnosis of puerperal sepsis secondary to genital tract infection were
evaluated with thorough details of history and examination to determine their demographic details,
obstetrical profiles, presenting features, state of infectious morbidity, need for intervention and
mortality related to puerperal sepsis. Results: Puerperal sepsis was 1.7% of all obstetrical admissions
and 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 membranes
from 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 of
conception, 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 mortality
was 6/42 (14.2%). Conclusion: Puerperal sepsis is an important public health problem contributing to
maternal morbidity and mortality. Majority of predisposing factors are preventable. Optimal antiseptic
measures 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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