PUERPERAL

SEPSIS

Meghana Dilip Pawar

Definition
 Puerperal sepsis refers to the condition of
developing fever in women after delivery.
Regrettably, this fever is caused by
external infections during childbirth. Use of
unclean medical instruments on her
private parts and touching the mother
with unsanitized hands are major causes
behind the infection. The unhygienic
environment at a health facility usually
induces the fever.
Causes
 It is mainly a bacterial disease. The bacteria known
to cause the infection include chlamydia,
clostridium welchii, clostridium tetani, E. coli,
gonococci, streptococci, and staphylococci. They
can enter the body during labor pelvic
examinations if the health professional is untrained
and careless. Prolonged labor also increases the
chance of infection. Most commonly, the infection
develops in the raw interior surface of the uterus
after the detachment of the placenta. Unsterilized
surgical instruments during a C-section can also
cause it.
Causes
 Any kind of laceration in the genital tract can cause the
disease. The extent of the affliction depends on the type of
microorganism, the resistance ability of the infected tissues
(or the lack of it), and the overall general health of the new
mother. Besides the genitalia, the urinary tract is also prone
to contacting the infection. It can be very serious.
Sometimes, it can be polymicrobial. Without immediate
attention, the microbes may multiple rampantly in the
blood stream and lead to internal poisoning. They also
affect the lymphatic system.
There are three main types of infection depending on the
location.
 Endometritis affects the internal lining of the uterus
 Metrophlebitis affects the uterine veins
 Peritontiis affects the membranous lining of the abdomen
Symptoms
 During pregnancy and especially during
delivery, the immune system of the
mother is rendered very weak. All that loss
of blood and the stress of pregnancy
naturally weakens the immunity. An
infection in the vaginal or the urinary tract
during this sensitive period may soon peak
to it’s worst. It is extremely vital to note the
symptoms of the condition and access
medical treatment at the first signs.
Symptoms
 foul smelling secretion from the uterus, also
consisting of pus
 High fever greater than 38 degree centigrade
or 100.4 degree Fahrenheit
 Chills
 Abdominal cramps
 Tenderness and pain in the uterus
 Failure of uterus to resume to the normal size
 Malaise
Risk Factors
 Risk for developing an infection after you
deliver is different depending on the method
used to deliver your baby. Your chance of
contracting an infection is:
 1 to 3 percent in normal vaginal deliveries
 5 to 15 percent in scheduled cesarean
deliveries performed before labor begins
 15 to 20 percent in non-scheduled cesarean
deliveries performed after labor begins
Risk Factors
 anemia
 obesity
 bacterial vaginosis, a sexually transmitted infection
 multiple vaginal exams during labor
 monitoring the fetus internally
 prolonged labor
 delay between amniotic sac rupture and delivery
 colonization of the vaginal tract with Group B
streptococcus bacteria
 having remains of the placenta in the uterus after delivery
 excessive bleeding after delivery
 young age
 low socioeconomic group
Complications
 Complications are rare. But they can develop if the
infection isn’t diagnosed and treated quickly.
Possible complications include:
 abscesses, or pockets of pus
 peritonitis, or an inflammation of the abdominal lining
 pelvic thrombophlebitis, or blood clots in the pelvic
veins
 pulmonary embolism, a condition in which a blood
clot blocks an artery in the lungs.
 sepsis or septic shock, a condition in which bacteria
get into the bloodstream and cause dangerous
inflammation
Preventions
 taking an antiseptic shower on the
morning of surgery
 removing pubic hair with clippers rather
than a razor
 using chlorhexidine-alcohol to prepare
the skin
 taking extended-spectrum antibiotics
before surgery
Homoeopathic Remedies
Apis mel :
 Suppressed menses with congested or inflamed
ovaries.
 Menses stop suddenly or cases for two or three
days to begin again , blood black.
Dysmenorrheoa with scanty discharge of slimy
blood.
 Chlorosis with puffy , bloated , waxy
appearance of the face , oedematous swelling
of the eyelids. Labia and feet.
 A peculia annoying arching or pain in the
ovaries especially in the right one, usually shortly
before or during menstruation.
China
 Pale face with blue margins around the eyes .
 Headache especially at night, falness and distension of the
abdomen, particular after eating with desire to eructation
which affords no relief
 Emanciation great debility with languor and heaviness of the
lower limbs.
 Sleeplessness or restless sleep with anxious or fatiguing dreams.
Rush and blood to the head with pulsation of the crotids.
 Nymphomania , nervousness, great sensitiveness to the least
noise.
 < Slightest touch, draught of air
 < loss of vital fluids
 < Eating binding over
 > hard pressure, bending double , warmth.
Gelsemium
 Amenorrhoea patient drowly and apthetic , sharp
darking and twitching neuralgic pain in face and head.
 Sensation as if uterus were Squeezed .
 Patient becomes dizziness, drowsiness, dullness and
trembling.
 Slow pulse tired feeling, mental apathy. paralysis of
various groups of muscles about the eyes thereof chest
larynx, sphiceter , extremities.
 Mentally desire to be quiet to be left alone, dullness
languor listless.
 Apathy regarding his illness , desiring are lethargid
 < damp weather. Fog, before thunderstorm
 > bending forward, by profuse urination.
Arnica
 Metrorrhagia after coition during pregnancy and from
prolaps uterus.
 Flooding after cases of convulsion as from a blow or fall
or riding over rough roads.
 Blood bright red or mixed with dots, heat abool head,
extremities cool, nausea in pit of stomach.
 Menorrhagia with pain in small of back , extending into
grain and down in inner side of leg down to the toes
since lympanitis.
 Uterine haemorhagia from mechanical injury after
coition.
 Fear touch or the approach and anyone unconseous.
 < Least touch, motion , rest
 > lying down , with head lows.
Belladonna
 Profuse discharge of bright red blood with feels hot as if escapes
from the vulva.
 The blood flows profusely between the after pains
 Vascular excitation showing itself by throbbing of the carotid,
flushed face, red eyes, full bounding pulse.
 Nausea with rumbling in the whole abdomen with great weight
from above downwards.
 Gentile pressure on the uterus causes nausea.
 There is wavelike feeling an undulating sensation or pulsation
tumor all over the body from head to foot, a sick pulsation
tremor all over the body.
 Offensive menorrhogea frequently indicated in uterine
heamorrhage after labour.
 < touch, jar, noise, drought.
 > semi erect.
Carbo Veg
 Persistent haemorrhage of a low type often from
degeneration of the sexual organs with burning
pain across sacrum and lower part of spine with
burning pain in chest and difficult breathing.
 Patient want to be fanned, skin cold and bluish ,
pulse rapid and weak , excessive prostration .
 Tetery eruption on nape of neck and between
shoulder.
 Skin blue , cold ecchymosed, marbled with
venous over distension.
 < evening , night , open air
 From eructation , fanning cold.
Calc. Phos
 Menses too early in young with bright red, blood too late
blood first bright then dark with worm, dark blood in
rheumatic women, menses during lactation.
 Before great sexual desire followed by copious flow
headache three to seven days before griping and
rumbling in bowels.
 During uertigo and throbbing in forehead pressure our os
pubis.
 She feels pulse in all parts want of appetite diarrhoea,
lower limb heavy , fatigued.
 < morning after rising of sweetish odour, for two weeks
after menses.
 > summer , warmth.
Chamomilla
 Too early and too profuse with dark coagulable
sometime offensive blood.
 Membranous dysmenorrhoea suppressed menses
before frontal headache with icy, cold hand and feet ,
cutting colic in abdomen and thighs.
 Irritable and snappish during profuse discharge of dark
clotted blood , with secure labor like pain in uterus.
 Tearing pain down the thighs chawing from small of
back forward.
 Gripping and pinching in uterus followed by discharge
at large clot of blood.
 < heat, anger, open air
 > carried warm wel weather.
Colocynthis
 Several days before menses sharp darting
paroxysmal pains in uterine region , bending her
double.
 > Pressure on painful parts and by warmth with
extreme nausea and vomiting and cold feel.
 Difficulty of breathing during flow , pain in left
ovarian region as if the part were squeezed in a
wise all creasing on appearance of flow , on
last day of menses pains rectum.
 < by eating drinking, flow rather increased
 > doubling up, hard pressure, warmth.
 > lying with head bent forward.
Conium
 Menses irregular, too early and too feeble or too late
and too scanty of brownish colored blood.
 Before great anxiety, weeping mood great food when
being alone, but dreads coming and stranges.
 Vertigo when lying down and < by turning over
 Mamme swell become hard and painful.
 During dysmenorrhoea with pain extending to left chest,
labour like abdominal pain extending into thighs.
 Rash over body of small red pimples which burns
securely when scratched.
 < lying down, turning or rising in bed
 > while fasting , in dark motion , pressure.
THANK YOU..!!!