What is Puerperal Sepsis?
Necessary Tests for Puerperal Sepsis Diagnosis:
Some important investigation must be done to diagnose puerperal sepsis, those are listed below:
- Physical examination,
- Ultrasound scan (USS) of the pelvis,
- X-ray chest/abdomen (to detect perforations),
- Complete blood count (CBC),
- Urine full report(UFR),
- Wound swab ( perineal or abdominal),
- Blood culture, in the presence of chills or evidence of severe infection.
Puerperal Sepsis Treatment Guidelines:
- Start of intravenous broad-spectrum antibiotics without delay in suspicion of severe sepsis, with or without septic shock.
- If genital tract sepsis is suspected, start early treatment with a combination of high-dose broad-spectrum intravenous antibiotics.
- Start antibiotics after taking samples for microbiology. Amoxycillin- clavulanic acid – 1.2 gms. Intravenous 8 hourly or 625mg. oral 8 hourly/twice a day or Ampicillin 500mg. intravenous 6 hourly.
- Or start penicillin with gentamicin and metronidazole provides the broadest coverage.
- A combination of piperacillin/tazobactam or a carbapenem plus clindamycin provides one of the broadest ranges of treatment for severe sepsis.
- MRSA may be resistant to clindamycin, a glycopeptide such as vancomycin or teicoplanin may be added until the sensitivity is known.
- Breastfeeding limits the use of some antimicrobials; hence the advice of a consultant microbiologist should be sought at an early stage.
Complications are not so common but they can develop if diagnosis and treatment are not started quickly. Possible complications include:
- Abscesses or pockets of pus,
- Pelvic thrombophlebitis,
- Pulmonary embolism,
- Sepsis or septic shock.
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Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “[email protected]”