Revisiting Puerperal Sepsis in Obsteric Referal Centres in Port Harcourt, Southern Nigeria

Abstract

Background: As the frontier of knowledge expands, surgical skills improve; and with the advent of increasingly potent antibiotics, it is expected that puerperal sepsis and its complications as captured in the literature of studies will be on the down turn. With this in mind, we decided to find out what is current as par risk factors and complications of puerperal sepsis in these obstetric referral centres in Port Harcourt. Objective: To determine the risk factors and complications of puerperal sepsis at the University of Port Harcourt Teaching Hospital(UPTH), Port Harcourt and the River State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria. Methods: The case notes of these patients were retrieved from the medical records departments and relevant data extracted using a well-structured proforma.  Data collected included the demographic characteristics, booking status, background immune suppression (HIV/AIDS or DM), labour characteristics, place and mode of delivery, fetal outcome, length of hospital stay. Morbidities like septicaemia, pelvic abscess, disseminated intravascular coagulopathy among others; and the presence of mortality was also noted. The data was analyzed using SPSS version 23.0. Statistical analysis of data was done by Chi-square test. A p-value less than 0.05 was considered significant. The result is presented in tables of frequencies and percentages. Results: The prevalence of puerperal sepsis was 1.7%. Risk factors were low parity, unbooked status (84.35%) and wound infection (29.9%), among other intrauterine foetal death (22.8%), obstructed labour (14.2%) and perineal tear (11.0%). The main complications of puerperal sepsis noticed were prolonged hospital stay (58.3%) and septicaemia (13.4%); pelvic abscess (10.2%) and intestinal obstruction (4.7%) while (1)3.1% ended in mortality. Conclusion: Complications of puerperal sepsis were still high in these centres. Worrisomely, a huge number of these patients were unbooked.