Puerperal Sepsis.pptx

PUERPERAL SEPSIS PPT
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Puerperal Sepsis
Puerperal Sepsis ppt

1. PUERPERAL SEPSIS Ghanshyam medical education Micro T eaching Practice ON

2. INTRODUCTION What is puerperium? It is the period of about six weeks after child birth during which the mother’s reproductive organs return back to their original non-pregnant condition. What is sepsis? The presence of tissue of harmful bacteria and their toxins, through infection of a wound

3. Definition According to (World Health Organization) WHO puerperal sepsis is defines as the infection of the genital tract occurring at labour or within 42 days of the postpartum period. OR An infection of the genital tract which occurs as a complication of delivery or miscarriage is termed as puerperal sepsis. The primary site of infection are:- Perineum Vagina Cervix uterus

4. Difference between puerperal sepsis and RTI

5. SOURCES OF PUERPERAL SEPSIS 1. ENDOGENOUS 2.AUTOGENOUS

6. CONT… 3. EXOGENOUS

7. PREDISPOSING FACTORS OF PUERPERAL SEPSIS: Malnutrition Anemia Preterm labor Early rupture/PROM/PPROM Precipitate delivery Immunocompromised (eg:AIDS ) Diabetes . Obesity. Organisms of normal vaginal flora. ANTEPARTUM

8. Intrapartum Repeated vaginal examinations Dehydration Ketoacidosis during labor Traumatic vaginal delivery APH or PPH Retained bits of placental tissue or membranes. Prolonged labor . Obstructed labor Caesarean or Instrumental delivery.

9. CLINICAL MANIFESTATION Local infection (wound infection) Uterine infection Spreading infection (extrauterine infection)

10. Rise in temperature Pus formation Local wound becomes red and swollen PRISH (pain, redness, immobility, swelling, heat. Rise in temperature (>100.4 F) R ise in pulse rate >90 b/m Lochial discharge become offensive and copious. 1. Local infection 2. Uterine infection

11. 3. Spreading infection (extrauterine spread) Parametritis (the inflammation of the parametrium , the connective tissue of the pelvic floor) Constant pelvic pain Tenderness Rise in temperature with chills. Pelvic peritonitis Pyrexia with increase in pulse rate. Lower abdominal pain and tenderness and collection of pus.

12. Diagnosis General principle in investigations are:- To locate the site of infection. To identify the organism To assess the severity of the diseases. DIAGNOSTIC EVALUATION

13. History collection Antenatal, Intranatal and Postnatal history of any high risk factors for infection like anemia, prolonged labour and PROM.

14. CLINICAL EXAMINATION Thorough general, physical and systematic examination, abdominal examination are done to locate specific site of infection.

15. INVESTIGATION INCLUDES H igh vaginal and endocervical swabs for culture in aerobic and anaerobic media and sensitivity test for antibiotics. Blood culture if fever is associated with chills. Pelvic ultrasound to detect any retained bits of conception within the uterus, to locate any abscess within the pelvis

16. Medical management Antibiotics: Ideal antibiotic regimen should depend on the culture and sensitivity report . Gentamicin (1.5mg/kg/8 hourly) + Clindamycin (900mg/8 hourly ) Metronidazole (500mg/12 hr)+ Penicillin (5 million units/6 hr ) Ampicillin (2gm/6hr) + gentamycin

17. SURGICAL MANAGEMENT Stiches of the perineal wound.. Surgical evacuation

18. NURSING MANAGEMENT Isolation of the patient Adequate fluid and calorie. Ensure the wound is cleaned with sitz bath several times a day and is dressed with an antiseptic ointment. Demonstrate and encourage correct perineal cleaning after voiding and defec-ation and frequent changing of the perineal pads. Demonstrate proper fundal massage. Monitor temperature, pulse and respiration Change client’s position frequently. Provide comfort measures. eg . back rub. Administer antibiotics as prescribed.

19. Thank you