Puerperal sepsis and maternal outcome in developing countries: an observational study

Naina Kumar, Ashu Yadav


Background: Puerperal sepsis is a major cause of maternal morbidity, mortality. Present study was conducted to know burden of severe puerperal sepsis, risk factors, maternal outcome.  

Methods: Present observational cohort study was conducted in the Obstetrics and Gynecology department of rural tertiary center of Northern India over eight months (1st January-31st July 2018). All women who had delivered or aborted in an institution or those referred from outside within 42 days of delivery/abortion having clinical features, investigations suggestive of puerperal sepsis were enrolled. Socio-demographic factors, clinical features, examination findings, investigations, details of antecedent pregnancy, complications, risk factors, and maternal outcome were recorded. Statistical analysis was done using SPSS version 22 software.

Results: A total of 66 cases with severe puerperal sepsis were observed during the study period of which 55 (83.3%) were referred from outside. The most common mode of delivery in antecedent pregnancy was vaginal (42.4%) followed by cesarean section (33.3%) and one (1.5%) forceps delivery. There were 15 (22.7%) post-abortal cases. Maternal anemia was found to be significantly linked with sepsis and adverse maternal outcome (p<0.05). Most common presenting features were fever (100%), tachycardia (100%), breathlessness (100%), malodourous vaginal discharge (100%), abdominal distention (53.0%), scar infection (16.7%), vaginal or rectal bleeding (16.7%), peritonitis (27.3%), septic shock (12.1%). A total of 38 (57.6%) cases required surgical intervention with seven (10.6%) developing multiorgan failure and 15 (22.7%) succumbed to death.

Conclusions: Though puerperal sepsis is a preventable condition, it continues to be one of the major causes of maternal morbidity, mortality.


Abortion, Delivery, Fever, Pregnancy, Puerperal sepsis

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