Gas gangrene in pregnancy, parturition, and abortions requiring urological and surgical intervention: Patterns, features, and world distribution

Abstract

Introduction: Gas gangrene in pregnancy and its outcome has a poor prognosis. The aim of this study is to determine the patterns of its occurrence worldwide, and the evolution of its treatment within the last 6 decades. Materials and methods: The study was done at the University of Port Harcourt Teaching Hospital, Nigeria. Using search terms, a bibliographical search was made in the PubMed/ Medline and PubMed Central computerized databases for articles published on the subject from 01/01/1966 to 31/12/2022. Details of each publication, including the date and location of the study, number and socio-demographic information on affected patient(s), clinical features of the disease, laboratory investigations, types, and outcome of treatments were recorded. Results obtained were collated with simple statistics and presented. Results: Ninety-five (95) study reports on 153 patients were seen and studied. The disease has global distribution. The number of study reports significantly correlated positively with the number of treated patients. There was no significant increase in the number of study reports, and the number of cases during the study period, P>0.50. The pattern of treatment was focused on aggressive life-saving surgical excision of all involved tissues. In some cases, these ablative procedures either had fatal complications, or left many patients with loss of vital organs and body parts, with poor functional and cosmetic outcomes. Conclusion: The dearth of records suggests that, generally worldwide, experience with the disease may be limited. A program of development of conservative treatment of the disease, and pre-pregnancy immunization of women of childbearing age is advocated.