Clinicopathological study of puerperal sepsis including microbiological profile: at a tertiary health care centre

Abstract

Background: Puerperal sepsis in developing countries is a major health problem. Antenatal and labour related risk factors play a huge role in causing puerperal sepsis, many of which are modifiable. The aim of the present study is to study the risk factors, clinical features and outcomes of puerperal sepsis in the mother and determine the causative microorganisms involved.Methods: A prospective observational study was conducted at the department of Obstetrics and Gynaecology, Assam Medical college and Hospital from 1st July 2016 to 30th June 2017.Peurperal sepsis cases were identified based on the WHO clinical definition. A total of 88 patients were identified. Information regarding occupation, antenatal care, delivery related events and outcome were recorded on a predesigned proforma. Mothers were followed up till discharge from the hospital.Results: Out of 88 clinically diagnosed patients with puerperal sepsis, common risk factors associated with mortality were young age(p<0.001),primiparity(p 0.005),tea garden workers(p 0.014),few antenatal check-ups and unbooked status (p 0.001) inadequate iron prophylaxis .Among labor related events intrauterine fetal demise (p 0.001), absent membranes on admission (0.001),late presentation (p 0.001) delivery by untrained birth attendant (p <0.001) were significant.24 patients expired due to the disease. Most common isolated in high vaginal swab and blood culture were Klebsiella pneumoniae and CONS respectively.Conclusions: Proper antenatal care and institutional deliveries are the prime and only preventive measure to reduce the burden of puerperal sepsis in our setup.