PEUPERIUM SEPSIS PRESENTATION NOTES., Lecture notes of Nursing

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PEUPERIUM SEPSIS

PRESENTATION

NOTES BY

ELIASPARAMEDIC.

Definitions e The puerperium is defined as the 6 weeks period commencing after the completion of third stage of labour. ia \ a -E.M SYMONDS e The puerperium is refers to the 6 weeks period following child birth, when considerable adjustments occur before return to the pre pregnant state. -PHILIP N. BAKER e Puerperium is defined as the time from delivery of the placenta through the first few weeks after the delivery. (cont....) WHAT IS SEPSIS”? ° The presence in tissues of harmful bacteria and their toxins, typically through infection of a wound. ° Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. DEFINITION OF PUERPERAL SEPSIS * According to The World Health Organization (WHO), puerperal sepsis is defined as the infection of the genital tract occurring at labour or within 42 days of the postpartum period. ° An infection of the genital tract which occurs as a complication of delivery or miscarriage is termed as puerperal sepsis. (DC DUTTA) - The primary sites of infection are: (1) perineum, (2) vagina,(3)cervix, (4) uterus. DIFFERENCE BETWEEN PUERPERAL SEPSIS - An infection of the genital tract which occurs as a complication of delivery OR miscarriage within 6 weeks is termed puerperal sepsis. REPRODUCTIVE TRACT INFECTION * Infection of external and/or internal reproductive organs. PREDISPOSING FACTORS OF PUERPERAL SEPSIS: ANTEPARTUM - Malnutrition Anemia Preterm labor Early rupture/PROM/PPROM Precipitate delivery Immunocompromised (eg:AIDS) Diabetes Obesity Organisms of normal vaginal flora.[ details next slidel 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 Instriumental delivervw. DODERLEIN’S BACILLI —_ These bacteria have a beneficial effect by _ = inhibiting growth, a adhesion or spread of ‘ on other =k. 4™ a microorganisms. a 4 a ad =~ Candida albicans * Candida albicans is an opportunistic pathogenic yeast that is a common member of the human gut. * Itis usually a commensal organism, but can become pathogenic in im munocompromised indivi duals under a variety of conditions. Staphylococcus aureus lt is aa commensal member of the normal flora of the body, frequently found in the nose respiratory tract gut mucosa and on the skin. & Bacteroides They are normally mutualistic organisms in gut help in processing of complex molecules eg: sugar to simpler ones in the host intestine. They converts these sugars to fermentation neh, products which are %, 57, beneficial to humans. They also have the ability é to remove side chains from bile acids, thus ‘ returning bile acids tothe =) 5 hepatic circulation. CAUSAL ORGANISMS AEROBIC BACTERIA ANAEROBIC BACTERIA OTHERS CAUSAL ORGANISMS AEROBIC * Group A beta-hemolytic Streptococcus (GAS) ¢ Group B beta-hemolytic Streptococcus (GBS)- Methicillin-resistant Staphylococcos aureus (MRSA) ANAEROBIC ¢ Streptococcus, Peptococcus, Bacteroides (fragilis, bivius), Fusobacteria, Mobiluncus and Clostridia. Others-Staphylococcus pyogenes S. aureus, E. coli, Klebsiella, Pseudomonas, Proteus, Chlamvdia. Group B beta-hemolytic S Streptococcus (GB = 7