Introduction: Globally, puerperal sepsis is one of the leading causes of maternal mortality and morbidity. It is the 2nd leading cause of maternal deaths in Bangladesh. Objective: The study was designed to identify the common socio-economic and demographic factors related to puerperal sepsis presented at tertiary level hospitals in Bangladesh. Methodology: A case control study was conducted between April 2011 and December 2011 in two tertiary level hospitals (Dhaka Medical College Hospital and Sir Salimullah Medical Collage Hospital). 35 cases who met the criteria of WHO for puerperal sepsis was included in the study as the cases while 105 cases were selected from the same hospitals as control participants. Both cases and controls were between 15 to 40 years old. Frequency distributions and calculation of means, standard deviation and Odds Ratio were done. Chi-square test and logistic regression analysis was also performed to find out the association between independent and dependent variables.
Keywords:Puerperal sepsis, Bangladesh, socio-demographic factor, tertiary hospital
Research ArticleOpen Access
IntroductionPuerperal infections/sepsis is a major public health and historically considered as a common pregnancy-related condition, which could eventually lead to obstetric shock or even death. It is a preventable disease which occurs within six weeks of giving birth [1]. According to the World Health Organization (WHO), puerperal infections/ sepsis is the sixth-leading cause of deaths among new mothers while it contributes 15% of total maternal deaths globally among the mothers of the reproductive age [2]. The global incidence of puerperal sepsis is 4.4 per 100 live births [3]. According to the WHO, proportion of maternal deaths due to puerperal sepsis are 9.7%, 11.6% and 7.7% in Africa, Asia and Latin America and the Caribbean respectively. On the other hand puerperal sepsis contributes only 2.2% of maternal mortality in developed countries. The Odds Ratios are 2.71, 1.91 and 2.06 in Africa, Asia and Latin America and the Caribbean respectively comparing to the developed world [4]. It is found as one of the leading cause of maternal deaths in the intensive care unit in the USA [5]. In Nigeria, puerperal sepsis is the 3rd leading cause of maternal mortality and contributes 12% of maternal mortality [6]. The incidence of puerperal sepsis in different African countries are 1.7, 0.22, 1.14 and 0.07 per 100 live births in Nigeria, Niger, Uganda and South Africa respectively [7]. Several studies from Pakistan established puerperal sepsis as the 3rd leading cause of maternal mortality [8] and the incidence is 10-15 per 100 live births [9]. Another study from Pakistan also identified 13 to 16% of all maternal deaths occurred in the post-partum period and puerperal sepsis contributed 12.4% of those deaths [10]. A study from Senegal demonstrated an incidence of sepsis of 8.7 per 100 live births for home deliveries compared to 1.9 per 100 live births for deliveries in health facilities [11].In Bangladesh, infor...