Risk factors and microbial isolates of puerperal sepsis at the University of Maiduguri Teaching Hospital, Maiduguri, North-eastern Nigeria

Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, P.M.B. 1414, Maiduguri, Nigeria.
Archives of Gynecology (Impact Factor: 1.36). 09/2011; 285(4):913-7. DOI: 10.1007/s00404-011-2078-4
Source: PubMed


To determine the risk factors and microbial isolates of puerperal sepsis.
A 12 year retrospective review of patients with puerperal sepsis from January 1999 to December 2010 at the University of Maiduguri Teaching Hospital (UMTH) was conducted. Information on socio-demographic characteristics, clinical presentations, place and mode of delivery and microorganism isolated from the endocervical swabs was collected and analysed. Comparison was also made with the other women that delivered during the period of study.
The incidence of puerperal sepsis was 0.78%. Majority (88.0%) of the patients were unbooked, 59.1% delivered at home and 23.1% delivered in other peripheral hospitals. The major risk factors for developing puerperal sepsis were unbooked status, home delivery, perineal trauma, caesarean section (C/S) and maternal age <24 years with OR of 56.60, 39.25, 8.52, 4.99 and 1.32, respectively. The commonest microorganism isolated were Staphylococcus aureus and Escherichia coli seen in 35.4 and 20.9%, respectively. Streptococcus species was found in 6.9%, while 20.3% had polymicrobials isolated.
Puerperal sepsis continues to present a significant risk of maternal mortality in developing countries. The risk factors are unbooked women, home delivery, perineal trauma, caesarean section and maternal age <24 years. S. aureus and E. coli are the commonest isolated organisms. There is a need to enlighten the populace on the need for booking, skilled attendant at delivery and hospital delivery under aseptic conditions.

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    • "S aureus is an important peri-natal pathogen in many areas of the developing world. For example, in Nigeria, it is both the leading cause of early onset neonatal sepsis50 and the leading cause of maternal sepsis in childbirth.51 In fact, the microbiological profiles of the causes of maternal and neonatal sepsis around the time of birth in Nigeria are remarkably similar to the causes of maternal UTI (Figure 2). "
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