Peuperial sepsis


1. Peuperial sepsis:-
 It is an infection of the genital tract by organism occurring within 12-14, days after child birth or abortion. Sepsis is caused mainly by 2 types of organism.
a. Endogenous Organism:- It usually lives in anus and in the perineum Anaerobic streptococci and clostridium welchi which  are found n vagina are responsible for injection.
b. Exogenous Organism:- This comes from outside the body by another person , source of infection is dust.
Causes:
- Poor hygiene.
- Incompleteness of placenta.
- Prolong labour.
- Recurrent catheterization which follows infection.
 - Use of dirty clothes and pad is also a source of infection.
Signs and symptoms:
- Fever which occurs within 24 hrs or more is 1st sign.
- Uterus is sub involuted tender and softer than usual.
- Vaginal discharge after delivery is foul smelling.
- Local pain and swelling of infected suture line.
- Headache , in somnia , anorexia.
In severe sepsis:
- Constant pelvic pain.
- Rise in temperature with increase pulse rate.
- Lower abdomen pain.
- Intense pain which worsen the condition of patients.
- Collection of pus in the pouch of doughlas.
- Severe infection of fallopian tube.
2. Peuperial pyrexia:-
  It is defined as the presence of fever in a women within 14
 days of giving birth that is greater than 38 C.
Causes:
UTI- Dysuria , haematuria.
- Genital tract infection.
- Tender bulky uterus , inflamed perineum.
Mastitis:
- Nipple.
- Engorge Breast.
- Post operative infection following c/s.
- Deep venous thrombosis.
Prevention:
- Scrupulous attention to hygiene should be used during all
   examination and instrument during labour.
- Use of prophylactic antibiotics during prolong labour.
- Catheterization should be avoided where possible.
- Early mobilization after delivery helps to protect against
   thrombosis.
- New mother should be helped to acquire the skills required
   for successful breast feeding.
- Perineal wound should be cleaned and sutured as soon as
   possible.
- All blood looses and the completeness of placenta should be
  recorded at all delivery.




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