Incidence Of Postpartum Infection Research Articles

Hubungan Perdarahan dan Partus Lama pada Ibu Post Partum dengan Kejadian Infeksi pada Masa Nifas

Postpartum infection is an infection occurring after childbirth up to 42 days postpartum, characterized by fever, pelvic pain, foul-smelling lochia, and subinvolution of the uterus (delayed return of the uterus to its pre-pregnancy state). The leading causes of maternal mortality in Indonesia include hemorrhage, hypertensive disorders during pregnancy, infections, and metabolic disorders, with 25-50% of maternal deaths related to pregnancy, childbirth, and the postpartum period. This study aims to determine the relationship between hemorrhage and prolonged labor in postpartum mothers with the incidence of postpartum infections. The research used an analytical method with a retrospective approach. The population consisted of all postpartum women with infections, totaling 30 respondents in 2022. The sampling technique used total sampling with 30 respondents. Data analysis was performed using the chi-square test. The results showed a significant relationship between hemorrhage (p=0.03) and prolonged labor (p=0.04) with the incidence of postpartum infections at H. Abdul Manap Hospital, Jambi City, in 2023. The conclusion of this study is that there is a relationship between hemorrhage and prolonged labor with the incidence of postpartum infections at H. Abdul Manap Hospital, Jambi City.

The Rate of Cesarean Section and Newborn Apgar score In Two Types Of Physiological Delivery and Facilitated Delivery in Mothers with First Pregnancy.

Labor pain is often severe and its lack of relief can have a bad effect on the mother's physiological condition. Accurate measurement and appropriate treatment of pain is an important problem. There are several choices for the control of labor pain, however, each method has its own risks and benefits regarding its efficiency and availability; therefore, the aim of this study was to compare the rate of cesarean section and newborn Apgar in two types of physiological delivery and facilitated delivery among mothers with first delivery. This case-control study was conducted on mothers aged 18-35 who went to the hospital to give birth. In the present study, 8 sessions (90 minutes each session) were held to prepare mothers from 20 to 37 weeks of pregnancy. Candidate mothers for physiological labor were hospitalized without intervention and in the active phase of labor, and their labor stages were planned physiologically. The pain intensity of mothers was asked using a scale (VAS) during labor every half hour (according to the pain scale from 0 to 10). The average score of pain during the first and second stages, type of delivery, amount of postpartum bleeding, length of the stage of delivery, infection, and fever after delivery, Apgar score of the baby, perineal status, mother's satisfaction and the rate of hospitalization of the baby in NICU were recorded. Furthermore, the level of satisfaction with childbirth was evaluated with the help of Mackey's standard satisfaction questionnaire. The average age of the physiological delivery and facilitated delivery groups was 26.37 ± 5.23 years and 26.58 ± 5.79 years, respectively. Physiological delivery significantly required less conversion to cesarean section. The most common etiology was caesarean section in the physiologic labor group, and a drop in NST was reported in the facilitated group. The analysis of the results demonstrated no significant difference between the etiology of cesarean section and the study groups. The Apgar score in the physiological group was significantly better than the facilitated group. There is no significant relationship between the study group and the amount of bleeding during delivery. Furthermore, there was no significant relationship between the study group and the incidence of postpartum infection. The rate of NICU admission in the facilitated group was found to be significantly higher than physiological delivery. The results of this study revealed that the rate of caesarean section, the rate of need for NICU, newborns' Apgar score, and the rate of mothers' satisfaction in physiological delivery group were significantly different from the other groups, but the rate of wound infection and the amount of postpartum bleeding in the two groups showed a significant difference.

Incidence of postpartum infections and outcomes associated with antibiotic prophylaxis after normal vaginal birth.

Antibiotic consumption accounted for approximately 15–20% of total drug costs in Thailand. From 2017 to 2018, 24.86% of Thai women who experienced vaginal delivery during normal term labour received antibiotics for postpartum infection. The Thai national practice guidelines set the target use of antibiotic prophylaxis in women following vaginal delivery of normal term labour to be no more than 10%. This study aimed to determine the incidence of postpartum infections and the outcomes and factors associated with antibiotic prophylaxis in women following vaginal delivery. The prospective cohort study was collected from 909 eligible patients who delivered infants in 7 secondary hospitals in Chiang Mai from July 2020 to February 2021. Antibiotic prescribing data and infections in women experiencing vaginal delivery during normal term labour were collected. The incidence of postpartum infections was calculated at 2 periods, 48 h and 6 weeks, after labour. Factors associated with the prescription of antibiotic prophylaxis in vaginal delivery were analysed using multivariate logistic regression. The results showed that the prevalence of antibiotic prescribing was 12.87% in a cohort of 117 patients. Postpartum infection was reported in 3 of 117 patients with antibiotics prophylaxis and 11 of 792 without antibiotics, with no statistically significant difference (RR: 1.04, 95% CI: 0.26–4.14; p = 0.956). Postpartum hygiene self-care practices were collected in the 6th week. The results found that there were no statistical differences in mean scores for all questions on postpartum hygiene self-care practices between the infected and non-infected groups (p-value > 0.05). One of the factors associated with antibiotic prophylaxis was third to fourth degree of tear and episiotomy (OR: 7.72, 95% CI: 1.13–52.75; p = 0.037 and OR: 2.41, 95% CI: 1.24–4.70; p = 0.010, respectively). There was no significance difference in postpartum infection among patients receiving antibiotic and those who did not receive antibiotics. Third to fourth degree of tear and episiotomy were significantly factors related to antibiotic prophylaxis in women with vaginal delivery after labour. This study supports practice guidelines and helps healthcare team to be assured on the use of antibiotics in no more than 10% of women experiencing normal vaginal delivery.

Perbandingan Komplikasi dan Keluaran antara Persalinan Pervaginam dan Seksio Sesaria pada Ibu dengan Riwayat Seksio Sesaria di RSD dr. Soebandi Jember


 The number of cesarean section in Indonesia is 9,8% and approaching cesarean limit suggested by WHO which is 10%. The most common reason for cesarean section is prior cesarean. Cesarean section has higher maternal mortality risk compared to vaginal delivery. Vaginal delivery with prior cesarean has higher complication risk compared to cesarean section. Maternal complications and neonatal outcomes are important to decide delivery methods. Maternal complications that can be compared are postpartum infection, postpartum hemorrhage, and uterine rupture. Neonatal outcomes that can be compared are APGAR score and neonatal birth injury. This study aimed to compare maternal complications and neonatal outcomes between vaginal delivery and cesarean section in women with prior cesarean section. There was a significant difference in the incidence of postpartum infection (p=0.01) and neonatal birth injury (p=0.05). There was no significant difference in APGAR score and the incidence of postpartum hemorrhage. There was no uterine rupture observed. In conclusion, vaginal delivery is a viable option for pregnant woman with prior cesarean.

Incidence of postpartum infection, outcomes and associated risk factors at Mbarara regional referral hospital in Uganda

BackgroundThere is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in sub-Saharan Africa. Retrospective studies estimate that puerperal sepsis causes approximately 10% of maternal deaths in Africa.MethodsWe enrolled 4231 women presenting to a Ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and measured vital signs postpartum. Women developing fever (> 38.0 °C) or hypothermia (< 36.0 °C) underwent symptom questionnaire, structured physical exam, malaria testing, blood, and urine cultures. Demographic, treatment, and post-discharge outcomes data were collected from febrile/hypothermic women and a random sample of 1708 normothermic women. The primary outcome was in-hospital postpartum infection. Multivariable logistic regression was used to determine factors independently associated with postpartum fever/hypothermia and with confirmed infection.ResultsOverall, 4176/4231 (99%) had ≥1 temperature measured and 205/4231 (5%) were febrile or hypothermic. An additional 1708 normothermic women were randomly selected for additional data collection, for a total sample size of 1913 participants, 1730 (90%) of whom had complete data. The mean age was 25 years, 214 (12%) were HIV-infected, 874 (51%) delivered by cesarean and 662 (38%) were primigravidae. Among febrile/hypothermic participants, 174/205 (85%) underwent full clinical and microbiological evaluation for infection, and an additional 24 (12%) had a partial evaluation. Overall, 84/4231 (2%) of participants met criteria for one or more in-hospital postpartum infections. Endometritis was the most common, identified in 76/193 (39%) of women evaluated clinically. Twenty-five of 175 (14%) participants with urinalysis and urine culture results met criteria for urinary tract infection. Bloodstream infection was diagnosed in 5/185 (3%) participants with blood culture results. Another 5/186 (3%) tested positive for malaria. Cesarean delivery was independently associated with incident, in-hospital postpartum infection (aOR 3.9, 95% CI 1.5–10.3, P = 0.006), while antenatal clinic attendance was associated with reduced odds (aOR 0.4, 95% CI 0.2–0.9, P = 0.02). There was no difference in in-hospital maternal deaths between the febrile/hypothermic (1, 0.5%) and normothermic groups (0, P = 0.11).ConclusionsAmong rural Ugandan women, postpartum infection incidence was low overall, and cesarean delivery was independently associated with postpartum infection while antenatal clinic attendance was protective.

A comparative study between the pioneer cohort of waterbirths and conventional vaginal deliveries in an obstetrician-led unit in Singapore

ObjectiveWaterbirth has been increasing in popularity in Asia (Lea W. Water babies. The Straits Times 17 February 2011. Available at http://www.nuh.com.sg/news/media-articles_1504.html). National University Hospital, Singapore, is the pioneer hospital offering waterbirths to women since 2006 in a unique setting of a consultant-led service and continuous foetal monitoring. To date, no studies have been done on the conduct of waterbirths in an Asia. This study aims to evaluate if water immersion during delivery is associated with increased rates of adverse maternal and foetal outcomes as compared with conventional vaginal deliveries. Materials and MethodsClinical records of women who birthed underwater at National University Hospital between 2010 and 2013 were retrospectively reviewed. Outcomes of interest were estimated blood loss, third- or fourth degree tears, incidence of postpartum infections or haemorrhage, neonatal Apgars at 1 and 5 min, and neonatal complications requiring intensive care unit admission. Outcomes were compared against a matched control group of women who had conventional vaginal deliveries within ≤1 month. ResultsRecords of 118 women who birthed underwater were accrued. There was no significant difference in estimated blood loss and postpartum haemorrhage between groups, and there were no cases of maternal infection, third- or fourth-degree perineal tears, or adverse neonatal outcomes in either group. Women in the control group were more likely to have episiotomies (63.6% vs. 0.85%; p < 0.01). Three cases of retained placenta were reported in the waterbirth group (0.03%). ConclusionWaterbirth at our centre does not appear to be associated with an increased incidence of adverse neonatal and maternal outcomes. The results of this study supported waterbirth as a birthing option to groups of low-risk women in an obstetrician-led setting with good midwifery support.

The Incidence of Postpartum Infections at Delivery, Post-Discharge Emergency Department (ED) Visit, and Six Week Readmission

The Incidence of Postpartum Infections at Delivery, Post-Discharge Emergency Department (ED) Visit, and Six Week Readmission

Postpartum sexually transmitted disease: refining our understanding of the population at risk.

Scant literature exists on sexually transmitted disease (STD) risk specific to pregnancy and postpartum. The objective of this prospective study is to examine risk factors for incident postpartum STDs among young mothers (ages, 14-25). Pregnant women were enrolled at <24 weeks gestation (N = 848). Data were collected via in-depth interviews and STD testing conducted in the second and third trimesters and at 6 and 12 months postpartum. Prevalence and incidence of STD diagnosis in pregnancy and postpartum is described. Logistic and linear regression are used to identify risk factors for postpartum infection. Forty-four percent of enrolled women never had an STD, 29% had a history of an STD before pregnancy, 28% got an STD during pregnancy, and 27% were diagnosed with an STD postpartum. Incidence of postpartum infection was higher for women who contracted an STD in pregnancy (43%) compared with those with a prior STD (24%) or no STD (19%). In multivariate analysis, STD in pregnancy, having less than high school education, having a new sexual partner, and black race were risk factors for incident postpartum STD. Prenatal providers should be aware of the significant risk of incident infection among women diagnosed with STDs in pregnancy. Elevated postpartum incidence among those with an STD in pregnancy supports a shift toward more frequent and targeted postpartum STD screening, with implications for clinical care, future research, and interventions.

Pyogenic Sacroiliac Arthritis Resulting in Septic Shock in a Postpartum Patient: A Rare Problem with a Rare Organism: A Case Report.

In developed countries, the incidence of postpartum infection following live childbirth is 6%1. Septic shock is a rare sequela of postpartum infection, occurring in only 0.1 to 0.6 per 1000 deliveries2. The leading cause of infection after a vaginal delivery is mastitis, followed by urinary tract infection. Other causes include endometritis, episiotomy site infection, respiratory complications related to anesthesia, retained products of conception, and septic pelvic phlebitis1,3. Many postpartum infections are polymicrobial, but common pathogens include gram-positive organisms (Streptococcus and Staphylococcus species), gram-negative rods ( Escherichia coli ), sexually transmitted pathogens ( Chlamydia trachomatis ), and anaerobic bacteria4. Osteoarticular infection after childbirth is perhaps the rarest of postpartum infections, and there are little data about its incidence. Case reports describing septic arthritis of the sacroiliac joint or osteomyelitis of the pelvis have been published5-8. In all of these reports, common pathogens such as Staphylococcus aureus or E. coli were the causative agents. We report a case of acute pyogenic sacroiliac arthritis caused by Fusobacterium necrophorum resulting in septic shock following an uncomplicated, spontaneous vaginal delivery. To our knowledge, no such report has been published previously in the literature. The patient was informed that data concerning her case would be submitted for publication, and she provided consent. Eleven days following an uncomplicated, spontaneous vaginal delivery (with an episiotomy) of a healthy baby girl, a previously well, gravida-1, para-1, nineteen-year-old woman presented to a community urgent care clinic with progressive fatigue and non-bloody diarrhea as well as abdominal, back, and buttock pain. She denied having had fevers, chills, or night sweats. Physical examination revealed tachycardia, tachypnea, and hypotension. Laboratory data revealed acute renal failure (creatinine [Cr], 3.8 mg/dL [normal, 0.4 to 1.1 mg/dL]), a white blood-cell count (WBC) of 10,800/μL (normal, 4.0 …

Uterine infections in the postpartum cow: I. Effect of dietary crude protein restriction

The relationship between adequate (0.96 kg per head daily) and deficient (0.32 kg per head daily) intake of crude protein between 150 days prepartum and 110 days postpartum and the incidence of postpartum infections in the bovine uterus was studied. The incidence of infection at 25 days postpartum was 52.2% and 48.1% (P > .10) for cows in the protein adequate and protein deficient groups, respectively. However, at 40 days postpartum, 21.7% of cows in the protein adequate group had infections vs 51.9% (P < .05) of cows in the protein deficient group. In addition, the incidence of infection within the protein adequate group between sampling times was different (P < .10); whereas, the incidence within the protein deficient group between sampling times was not different (P > .10). Eighty-three bacterial isolates representing 27 species were recovered from the total of 100 samples. Corynebacterium pyogenes and Fusobacterium necrophorum were the most frequently isolated aerobe and anaerobe, respectively. Although there was no difference between diets (P > .10), these two organisms occurred most frequently in cows on the protein deficient diet and were associated with clinically severe uterine infections. These data suggest that the amount of crude protein in the diet affects both the incidence and duration of postpartum infections in the bovine uterus.