Escolar Documentos
Profissional Documentos
Cultura Documentos
INFECTION
Puerperal
fever
Postpartum fever
Puerperal sepsis
Childbed fever
DEFINITION :
Bacterial infection following
childbirth
Infection of the birth canal after the
first 24
hours following delivery of a baby
Temperature > 38o C (taken by
mouth, 4
times daily)
Occur on any two of the first 10 days
Predisposing factors
1. Antepartum factors
Anemia
Nutrition
Sexual intercourse
PROM
2. INTRAPARTUM FACTORS
PATHOLOGY
Decrease of protective mechanism
Plasental site = portal of entry
The lochia = excellent culture
media
Ascending infection
Episiotomy infection
Perineal lacerations infection
Lesions of vulva/vagina and
cervix
do not occur more often
(due to excellent local blood supply)
large episiotomy greater risk
Vaginitis/Servicitis infection
during pregnancy
Bad hygiene
Episiotomy infection
Clinical findings :
Pain at episiotomy site
Dysuria with or without urinary
retention
Disruption of the wound
Gaping incision
Necrotic debris / pus
Body temp. < 38.5 oC
Episiotomy infection
Treatment :`
Cleaning the wound
Promoting formation
granulation
tissue
Debridement (Warm Sitz baths)
Perineoraphy
ENDOMETRITIS
Etiology :
PROM
Chorioamnionitis
Excessive number of vaginal
examinations
Prolonged labor
Vaginitis/Cervicitis
ENDOMETRITIS.
Intrauterine pressure
catheter
Low sosioeconomic status
Operative vaginal deliveries
Poor nutrition
Coitus near term
Endometritis
Clinical findings :
Symptoms and Signs :
Fever (between 38 oC s/d 40
o
C)
Soft & tender uterus
Lochia foul odor
Endometritis..
LABORATORY FINDINGS :
* Leukocytosis
* Urinalysis (pyuria/Bacterial
cultures) * Lochia cultures
* Sensitivity antimicrobial test
Endometritis.
Treatment :
Antibiotics ( Aerob & Anaerob
m.o)
(Ampicillin + Aminoglycosides)
(Cephalosporine 2nd/3rd
generation)
(Clyndamycin)
Uterotonic
Fowler position
Extension of Puerperal
Infection
1. Extension via superficial
epithelization
(Percontinuitatum)
Endometritis
Salpingitis
Pelveoperitonitis
Peritonitis
Salpingitis :
Septic Thrombophlebitis :
Repeated chills
pneumonitis
infarction
abscesses
septic embolism
Peritonitis
Severe abdominal
pain
Abdominal rigidity
Marked bowel
distension
Paralytic ileus
Treatment :
Choice of antibiotics
(penicillin + gentamycin)
(penicillin + aminoglycosides)
(clindamycin + gentamycin)
(penicillin + tetracycline)
Analgetic
Fluid & Electrolyt
Operative
PREVENTIVE CARE
1.During Pregnancy
anemia
nutrition
genital infection
coitus near term
PREVENTIVE CARE...
2. During parturition
Safe and Clean delivery
avoid infection (hygiene/antiseptic
procedure)
avoid large episiotomy
avoid bleeding
avoid prolonged labor
3. During puerperium
Hygiene