CARE OF A FAMILY

EXPERIENCING A
POSTPARTUM
COMPLICATION-
PUERPERAL
INFECTIONS
MODULE 14
1. PUERPERAL SEPSIS
 Infection of the reproductive tract

Conditions that increases the Risk for Post-partal Infection

 Rupture of membranes > 24h before birth
 Retained placental fragments
 Post partal hemorrhage- weakens the woman’s general condition
 Preexisting anemia-lowers body defense
 Prolonged & difficult labor, particularly instrument births
(forceps, etc.)
 Internal fetal heart monitoring
 Local vaginal infection at the time of birth
 The uterus was explored after birth for a retained placenta or
abnormal bleeding site

PUERPERAL
SEPSIS
Conditions that affect prognosis for complete recovery:
 Virulence of the invading microorganism
 The woman’s general health
 Portal of entry
 Degree of uterine involution at the time of microorganism
invasion
 Presence of lacerations in the reproductive tract

PUERPERAL
SEPSIS
TYPES OF INFECTION
1. Localized- involves lesions of perineum, vulva, vagina,
endometrium
*Endometritis”
2. Systemic infections

PUERPERAL
SEPSIS
Common infective agents:
 Group B streptococci
 Aerobic gram (-) bacilli like E. coli
 Staphylococcus aureus

PUERPERAL
SEPSIS
2. INFECTION OF THE PERINEUM
Assessment
 Usually localized
 May or may not have fever
 1 or 2 stitches may be sloughed from the suture line or an area
of the suture line may be open with purulent drainage present
Management
 Drainage of infected site and packing with iodoform
gauze on the open lesion
 Topical or systemic antibiotic even before culture results
are available
 Analgesic to relieve discomfort
 Sitz baths, moist, warm compresses, Hubbard tank
treatments to hasten drainage & cleanse the area

PUERPERAL
SEPSIS
 Remind woman to change perineal pads frequently to
prevent recontamination or vaginal infection
 Ask woman to wipe from front to back after bowel
movement

PUERPERAL
SEPSIS
3. ENDOMETRITIS
Assessment
 Increase in temperature of > 100.4F (38C) for 2 consecutive
24-hour periods, excluding the 1st 24 hours
 Chills, anorexia, general malaise
 the uterus is not well-contracted, painful to the touch with
strong after pains
 lochia is usually dark brown & foul-smelling, increased in
amount
 fever usually on the 3rd or 4th postpartal birth
 UTZ to check for retained placental fragments

PUERPERAL
SEPSIS
MANAGEMENT
 antibiotics after C & S, such as clindamycin
 oxytocic agent to encourage contraction
 Fluid replacement if necessary
 Analgesics as ordered for afterpains & abdominal
discomfort; antipyretics for fever

PUERPERAL
SEPSIS
 Fowler’s position or walking
 Wear gloves during perineal care
 For perineal infections, packing with iodoform gauze,
analgesics, systemic or topical antibiotics
 Sitz baths or warm compresses hasten drainage & provide
relief

PUERPERAL
SEPSIS
 THANK
YOU…….