Abstract

Puerperal sepsis is defined as the infection of the genital tract occurring at labor or within 42 days of the postpartum period. 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. This infection may originate at the placental site or within lacerations of the cervix, vagina, or perineum. Since puerperal sepsis is a preventable factor of maternal morbidity and mortality, the objectives of this study are to identify risk factors and to evaluate maternal morbidity and mortality from sepsis in Al-Sadaka Teaching Hospital. This study employed a descriptive, retrospective observational study design,evaluated10718 women of them 45 women going through puerperal sepsis, over a period of 18 months, presenting with symptoms and signs of puerperal sepsis/pyrexia. The demographic data showed that women aged 20-34 years (66.7%) were the most affected with a full term pregnancies (85%). Most (57.8%) of the respondents were of low parity level. The obstetric data showed that most (62.2%) of the respondents were delivered at hospital, 91.1% had spontaneous deliveries, and 60% of the deliveries attends by medical personnel. Anaemia was the main risk factor detected in all of the patients. Three quarters of the respondents develops the disease within the first 12 postnatal days, most frequent presenting complains were secondary PPH (17.8%), fever with foul-smell vaginal discharge (15.6%), sole presence of fever (11.1%), septicemia (8.9%) and Fever & abdominal pain (6.7%). Other morbidities associated with puerperal sepsis were found less frequently. Regarding the ultra-sound findings, signs of endometritis were present in more than three quarters of the case (80%). Monitoring of infection rates should become a priority in all maternity units and may be a preventive intervention in itself. The introduction of postpartum uterine scanning, especially for women with risk factors for puerperal complications, all need to be considered in order to improve the quality and safety of health facility care in our country.