Puerperal sepsis is an infection of the genital tract that arises between the onset of labor or membrane rupture and up to 42 days after childbirth. It is characterized by the presence of two or more of the following symptoms: pelvic pain, fever (a temperature of ≥38.5°C at least once), abnormal vaginal discharge, or a delayed rate of uterine involution.1 Background: Puerperal sepsis is a significant contributor to maternal illness and death related to pregnancy, particularly in developing nations. This condition is defined as a bacterial infection of the genital tract occurring within 28 days following childbirth, miscarriage, or induced abortion. Common sites of postpartum infections include the endometrium (endometritis), surgical wounds from cesarean sections or episiotomies, the urinary tract, and the breasts (mastitis). Puerperal infection is diagnosed when the patient presents with a fever of 100.4°F (≥38°C) or higher on two consecutive days within the first 10 days postpartum, measured orally at least 4 hours apart. However, healthcare providers should note that an elevated temperature in the first 24 hours post-delivery may result from the body’s normal physiological response
to labor and delivery stress. Cesarean deliveries are associated with a higher risk of puerperal infections compared to vaginal births, particularly when prolonged labor precedes the surgery. In such cases, the incidence of postpartum infections can rise to 30-35%. Since many infections develop after hospital discharge, it is crucial for nurses to educate mothers and their families about recognizing and reporting symptoms of infection to a healthcare provider promptly.2 Aim: To prevent maternal deaths and long-term morbidity by early identification and management of puerperal sepsis3 Objectives: The study aimed to assess the prevalence of puerperal sepsis and identify the factors associated with its occurrence.4 Material: The uterus is typically a sterile environment. However, bacteria naturally present on the skin, such as Streptococcus or Staphylococcus, and other microorganisms can cause infections by entering through damaged skin or tissue. These bacteria flourish in the warm and moist conditions of the lower abdomen. Postpartum infections can originate in the uterus after the rupture of the amniotic sac “water breaking”. Furthermore, the uterus is at risk of infection if the amniotic sac and its fluid become contaminated. The amniotic sac is a protective membrane that encloses the fetus and the surrounding fluid.5 Result: The prevalence of puerperal sepsis was found to be 10.7%. The average age of the patients was 25.85 ± 7.5 years, with a mean parity of 3.89 ± 4.5. A majority of the women (74.71%) had not attended antenatal care (“unbooked”) and delivered at home (69.3%). Fever was the most common presenting symptom, reported by 90.7% of the patients. Staphylococcus aureus was the most frequently cultured organism, identified in 75.0% of cases. Anemia was the most prevalent complication, affecting 63.6% of the women.6 Conclusion: The incidence of puerperal sepsis was 7.27%. Factors associated with its occurrence included a lack of formal education, cesarean delivery, premature rupture of membranes, complicated pregnancies, referral status, and the absence of a birth preparedness and complication readiness plan.7
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