Does Health Care Facility Delivery Reduces Puerperal Sepsis? An Analysis at a Tertiary Care Hospital
Objective: To compare the frequency, time lapse, management and outcome of patients with puerperal sepsis in health care facility deliveries versus home deliveries.
Methodology: It was a descriptive study with retrospective data collection conducted at department of Obstetrics, Liaquat University of Medical and Health Sciences, Jamshoro, from January 2017 to June 2020. Sampling of patients was done by non-probability based purposive technique. The inclusion criteria were any patient presenting within 42 days of vaginal delivery with diagnosis of puerperal sepsis without any co morbid illness while the patients with puerperal sepsis after caesarean section, instrumental delivery or abortion or vaginal delivery with co morbid illness were excluded. The patients were divided into 2 groups (Group1= Health facility, Group 2 = Home delivery). Details gathered through case records and data was analyzed by SPSS version 22.0.
Results: The frequency of puerperal sepsis was found to be 0.7%. Out of 121 cases, 58 patients were included in the study. There was no statistically significant association between place of delivery and frequency of cases. The majority of the patients were in the age group 20-30 years in both groups. The time lapse from symptoms to presentation was prolonged in group 2 but not statistically significant. Laparotomy, intensive care unit admission, and mortality were higher in group 2.
Conclusion: Puerperal sepsis after health care facility delivery is an emerging challenge demanding improvement in health practices. Training of traditional birth attendants about safe delivery and early referral can reduce home delivery complications.
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