OBJECTIVE: To determine the frequency, causative factors and outcome of delivery by trained
or untrained personnel.
STUDY DESIGN: Descriptive study.
SETTING: This study was done in the Gynaecology / Obstetric Unit-II, Liaquat University Hospital,
Hyderabad Pakistan from 1st January 2006 to 30th December 2006.
PATIENTS AND MEHTODS: All the patients who developed puerperal sepsis, delivered out side
the university hospital were included in this study, while those who were referred as a case of
retained placenta, other obstetric related postpartum morbidities like anaemia, puerperal psychosis,
breast abscess, UTI, or who developed postoperative surgical problem delivered at university
hospital were excluded from study.
RESULTS: Out of total 2885 maternal admissions 135 patients had various postpartum problems,
61 patients had puerperal sepsis. Majority (67.2%) was less than 30 years of age and
52.5% of low parity. Among study population 67.2% belonged to low scio-economic group and
96% were illiterate. Majority (67%) of women did not receive any level of care, only 9.8% had
level 3 care. Patients who had vaginal delivery were 93.4% while 6.6% had caesarean section. In
majority of patients (57.4%) high grade fever was the major symptom followed by distension of
abdomen in 26.2%. Evacuation of uterus and laparotomy were done in 39.3%, only evacuation of
uterus was carried out in 24.6% and 3.3% had hysterectomy. One third (32.8%) had prolonged
hospital stay and other one third (32.8%) died inspite of all possible measures.
CONCLUSION: The study conclude that in majority of women sepsis as well as maternal death
was preventable. It can be reduced by proper counseling of women about importance of antepartum,
intrapartum and postpartum care and training of Dais and refreshing courses of trained
birth attendants (TBAs).
Postpartum infection, Puerperal sepsis, Obstetric care.