Puerperal Sepsis
Infection of the genital tract that occurs at any time between
therupture of membranes in labour and 42 day following delivery or abortion
with the following symptoms.
·
Pelvic pain
·
Fever 38.50C or
more
·
Abnormal smell, foul dour of vaginal discharge
·
Delay in the rate of reduction of the size of the uterus.(sub
involution)
Cause
·
Endogenous bacteria
·
Exogenous bacteria
·
Poor hygiene
·
Poor aseptic technique
·
Manipulations in birth canal
·
Presence of dead tissue in the birth canal due to IUFD
·
Retained fragments of placenta or membranes shedding of dead tissue from
vaginal wall following obstructed labour.
·
Insertion of unsterile hand, instrument or packing / traditional
practices should also be examined/
·
Pre existing anemia and malnutrition
·
Prolonged of obstructed labour
·
Prolonged rupture of membrane
·
Frequent vaginal examinations
·
Caeserean section and other operative deliveries
·
Unrepaired vaginal or cervical lacerations
·
Preexisting sexually transmitted disease
·
Post partum hemorrhage
·
Not being immunized against tetanus diabetes
i.
Placental site
ii.
Perineum
iii.
Vagina
iv.
Cervix
v.
Uterus
Women are vulnerable to infection in the proportion because the
placental site is large, warm, dark moist, rich to grow very quickly. During
delivery traumatized tissue of tear in the vagina or perineal area is
susceptible to infection.
1. Isolation and Barrier nursing
of the woman
Nurse the woman in a separate room, use gloves only when attending her
keep one set of equipment, dishes and other utensils for the use of this woman,
wash hands carefully before & after attending this woman.
2. Administration of high doses
of antibiotics / Broad spectrum/
3. Give plenty of fluids:- the aim of this is to correct
orprevent dehydration and help to lower the fever. In severe cases it is
necessary to give IV fluids at first.
4. Ruling out Retained placental
fragments:-
suspect thisif the uterus is soft and bulky, if lochia are excessive and
contain blood clots, it can be a sign of puerperal sepsis. The woman should be
referred to a facility that has the equipment and health care personnel trained
to perform acurettage.
5. Providing skilled nursing
care:-
Careful attention to thecomfort of the woman. It is important for the woman to
rest, monitor uterine size, measure in take and out pout, keep accurate recurs,
prevent spread of infection and cross infection .Accurate observation,
recording and reporting.
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