The most important risk factor for development of post partum uterine infection/sepsis is:

Ans. is 'b' i.e., Route of delivery Puerperal Sepsis* An infection of the genital tract which occurs as a complication of delivery is called puerperal sepsis* Postpartum uterine infection has been called variously endometritis, endomyometritis, and endoparametritis. Because infection actually involves not only the decidua but also the myometrium and parametrial tissues, the preferred term is metritis with pelvic cellulitis.* The route of delivery is the single most significant risk factor for the development of uterine infection.* Compared with cesarean delivery, metritis following vaginal delivery is relatively uncommon.* Most female pelvic infections are caused by bacteria indigenous to the female genital tract.Predisposing Factors of Puerperal SepsisAntepartumIntrapartum1. Malnutrition1. Multiple cervical examinations2. Anemia2. Internal fetal monitoring3. Preeclampsia3. Chorioamnionitis4. PROM4. Retained placenta5. Immunocompromised status (HIV)5. PPH6. Diabetes mellitus6. Prolonged labor7. Obesity7. Operative delivery (LSCS)8. MSAF