Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 4/2012

01-04-2012 | Maternal-Fetal Medicine

Risk factors and microbial isolates of puerperal sepsis at the University of Maiduguri Teaching Hospital, Maiduguri, North-eastern Nigeria

Authors: Babagana Bako, Bala M. Audu, Zara Mairam Lawan, Jidda Baba Umar

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Login to get access

Abstract

Purpose

To determine the risk factors and microbial isolates of puerperal sepsis.

Methods

A 12 year retrospective review of patients with puerperal sepsis from January 1999 to December 2010 at the University of Maiduguri Teaching Hospital (UMTH) was conducted. Information on socio-demographic characteristics, clinical presentations, place and mode of delivery and microorganism isolated from the endocervical swabs was collected and analysed. Comparison was also made with the other women that delivered during the period of study.

Results

The incidence of puerperal sepsis was 0.78%. Majority (88.0%) of the patients were unbooked, 59.1% delivered at home and 23.1% delivered in other peripheral hospitals. The major risk factors for developing puerperal sepsis were unbooked status, home delivery, perineal trauma, caesarean section (C/S) and maternal age <24 years with OR of 56.60, 39.25, 8.52, 4.99 and 1.32, respectively. The commonest microorganism isolated were Staphylococcus aureus and Escherichia coli seen in 35.4 and 20.9%, respectively. Streptococcus species was found in 6.9%, while 20.3% had polymicrobials isolated.

Conclusion

Puerperal sepsis continues to present a significant risk of maternal mortality in developing countries. The risk factors are unbooked women, home delivery, perineal trauma, caesarean section and maternal age <24 years. S. aureus and E. coli are the commonest isolated organisms. There is a need to enlighten the populace on the need for booking, skilled attendant at delivery and hospital delivery under aseptic conditions.
Literature
1.
go back to reference Ekwempu CC Jr, Otubu JAM (2006) Abnormal puerperium. In: Akin Agboola (ed) Text book of obstetrics and gynaecology for medical student, chap 62. Heinemann, Lagos, pp 504–508 Ekwempu CC Jr, Otubu JAM (2006) Abnormal puerperium. In: Akin Agboola (ed) Text book of obstetrics and gynaecology for medical student, chap 62. Heinemann, Lagos, pp 504–508
2.
go back to reference The prevention and management of puerperal sepsis, report of a technical working group. WHO/FHE/MSM/95.4. Geneva Wold Health Organisation, 1995 The prevention and management of puerperal sepsis, report of a technical working group. WHO/FHE/MSM/95.4. Geneva Wold Health Organisation, 1995
3.
go back to reference Mairiga AG, Kawuwa MD, Kyari O (2008) A fourteen year review of maternal mortality at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Niger Hosp Pract 2(5):115–119 Mairiga AG, Kawuwa MD, Kyari O (2008) A fourteen year review of maternal mortality at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Niger Hosp Pract 2(5):115–119
4.
go back to reference FMOH. National HIV/AIDS and Reproductive Health Survey, 2007 (NARHS Plus). Federal Ministry of Health Abuja, 2008, pp 112–122 FMOH. National HIV/AIDS and Reproductive Health Survey, 2007 (NARHS Plus). Federal Ministry of Health Abuja, 2008, pp 112–122
5.
go back to reference Chisembele M (2004) The global incidence of puerperal sepsis, Geneva foundation for medical education and research postgraduate training course in reproductive health (pp 477–479) Chisembele M (2004) The global incidence of puerperal sepsis, Geneva foundation for medical education and research postgraduate training course in reproductive health (pp 477–479)
6.
go back to reference Poggi SBH (2007) Abnormal puerperium. In: Decharney AH, Nathan L, Goodwin JM, Laufer N (eds) Current diagnosis and treatment, chap 31. Mc Graw Hill, New York, pp 477–497 Poggi SBH (2007) Abnormal puerperium. In: Decharney AH, Nathan L, Goodwin JM, Laufer N (eds) Current diagnosis and treatment, chap 31. Mc Graw Hill, New York, pp 477–497
7.
go back to reference Smaill F, Hofmeyer GJ (2002) Antibiotic prophylaxis for caesarean section. Cochrane Database of systematic reviews, Issue 1 Smaill F, Hofmeyer GJ (2002) Antibiotic prophylaxis for caesarean section. Cochrane Database of systematic reviews, Issue 1
8.
go back to reference Dare FO, Bako AU, Ezechi OC (1998) Puerperal sepsis: a preventable postpartum complication. Trop Doctor 28:92–95 Dare FO, Bako AU, Ezechi OC (1998) Puerperal sepsis: a preventable postpartum complication. Trop Doctor 28:92–95
9.
go back to reference Dolea C, Stein C (2003) Global burden of maternal sepsis in the year 2000. Evidence and information for policy (EIP). World Health Organization, Geneva Dolea C, Stein C (2003) Global burden of maternal sepsis in the year 2000. Evidence and information for policy (EIP). World Health Organization, Geneva
10.
go back to reference Abouzahr C, Aaahman E, Guidotti R (1998) Puerperal sepsis and other puerperal infections. In: Murray CJL, Lopez AD (eds) Health dimensions of sex and reproduction: the global burden of sexually transmitted diseases, maternal conditions, perinatal disorders, and congenital anomalies. WHO, Geneva Abouzahr C, Aaahman E, Guidotti R (1998) Puerperal sepsis and other puerperal infections. In: Murray CJL, Lopez AD (eds) Health dimensions of sex and reproduction: the global burden of sexually transmitted diseases, maternal conditions, perinatal disorders, and congenital anomalies. WHO, Geneva
11.
go back to reference Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case–control study. BMJ 322(7294):1089–1093PubMedCrossRef Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case–control study. BMJ 322(7294):1089–1093PubMedCrossRef
12.
go back to reference Pradhan A (2005) Situation of antenatal care and delivery practices. Kathmandu Univ Med J 3(3):266–270 Pradhan A (2005) Situation of antenatal care and delivery practices. Kathmandu Univ Med J 3(3):266–270
13.
go back to reference Brennan M (1989) Training traditional birth attendants. Postgrad Doctor 11:16 Brennan M (1989) Training traditional birth attendants. Postgrad Doctor 11:16
14.
go back to reference Brentlinger PE, Capps L (1998) Pregnancy outcomes in El Salvador during the post-war period. Int J Gynaecol Obstet 61:59–62PubMedCrossRef Brentlinger PE, Capps L (1998) Pregnancy outcomes in El Salvador during the post-war period. Int J Gynaecol Obstet 61:59–62PubMedCrossRef
15.
go back to reference van Dillen J, Zwart J, Schutte J, van Roosmalen J (2010) Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis 23:249–254PubMedCrossRef van Dillen J, Zwart J, Schutte J, van Roosmalen J (2010) Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis 23:249–254PubMedCrossRef
16.
go back to reference Maharaj D, Teach DT (2007) Puerperal pyrexia: a review part 1. Obstet Gynaecol Survey 62(6):393–399CrossRef Maharaj D, Teach DT (2007) Puerperal pyrexia: a review part 1. Obstet Gynaecol Survey 62(6):393–399CrossRef
17.
go back to reference Akerele J, Abhulimen P, Okonofua F (2002) Prevalence of asymptomatic genital infection among pregnant women in Benin city, Nigeria. Afr J Reprod Health 6(3):93–97PubMedCrossRef Akerele J, Abhulimen P, Okonofua F (2002) Prevalence of asymptomatic genital infection among pregnant women in Benin city, Nigeria. Afr J Reprod Health 6(3):93–97PubMedCrossRef
18.
go back to reference Ekwempu CC, Lawande RV, Egler LY (1981) Microbial flora of lower genital tract of women in labour in Zaria, Nigeria. J Clin Pathol 34:82–83PubMedCrossRef Ekwempu CC, Lawande RV, Egler LY (1981) Microbial flora of lower genital tract of women in labour in Zaria, Nigeria. J Clin Pathol 34:82–83PubMedCrossRef
Metadata
Title
Risk factors and microbial isolates of puerperal sepsis at the University of Maiduguri Teaching Hospital, Maiduguri, North-eastern Nigeria
Authors
Babagana Bako
Bala M. Audu
Zara Mairam Lawan
Jidda Baba Umar
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-2078-4

Other articles of this Issue 4/2012

Archives of Gynecology and Obstetrics 4/2012 Go to the issue