Home delivery complicated with puerperal sepsis in urban India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20161347Keywords:
Puerperal sepsis, Home delivery, Obstetric hysterectomy, Pyoperitoneum, Maternal mortalityAbstract
Puerperal sepsis is among the leading and preventable causes of maternal morbidity and mortality worldwide and especially in developing countries. We report an interesting case of home delivery complicated with puerperal sepsis, who required obstetric hysterectomy. Inspite of being a resident of an urban metropolitan city patient had no access to antepartum, intrapartum or even postpartum care. She presented on day eleven postpartum to our institute by which time, her condition had progressed to frank pyoperitoneum and severe anaemia. Urgent, aggressive intervention in the form of evacuation of intra-abdominal pus, obstetric hysterectomy with oophorectomy saved her life.References
WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Trends in maternal mortality: 1990 to 2015. Geneva: World Health Organization. 2015:19.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels JD, et al. Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health. 2014;2(6):e323-33.
Gombar S, Ahuja V, Jafra A. A retrospective analysis of obstetric patient’s outcome in intensive care unit of a tertiary care center. Journal of Anaesthesiology, Clinical Pharmacology. 2014;30(4):502-7.
The prevention and management of puerperal infections: report of a technical working group 1992. Geneva: World Health Organization; 1995:3 http://apps.who.int/iris/bitstream/10665/59429/1/WHO_FHE_MSM_95.4.pdf. Acessed at 20 January 2016.
Maharaj D. Puerperal Pyrexia: a review. Part II. Obstet Gynecol Surv. 2007;62(6):400-6.
Hussein J, Walker L. Puerperal sepsis in low and middle income settings: Past, present and future in maternal and infant death: Chasing Millennium development Goals Edited by kehoes, Neilson JP, Norman JE, London: RCOG Press. 2010:131-147.
Royal College of Obstetricians and Gynaecologists (RCOG). Bacterial sepsis following pregnancy – 64b April 2012. RCOG Green top Guidelines. London: RCOG Press; 2012b. http://www.rcog.org.uk/womens-health/clinical-guidance/sepsis-following-pregnancy-bacterial-green-top-64b. Accessed 20 January 2016.
Census of India: SRS Statistical report 2012, Chapter 3 Estimate of fertility indicators. http://www.censusindia.gov.in/vital_statistics/SRS_Report_2012/10_Chap_3_2012.pdf. Accessed 20 January 2016.