Puerperal sepsis/infection occurs up to?

Ans- B 2 week PUERPERAL SEPSIS DEFINITION Puerperal sepsis is any bacterial infection of the genital tract which occurs after the birth of a baby. It is usually more than 24 hours after delivery before the symptoms and signs appear. Some of the most common bacteria are: streptococci staphylococci escherichia coli (E.coli) clostridium tetani clostridium welchii chlamydia gonococci SYMPTOMS AND SIGNS are fever (temperature of 38degC or more) chills and general malaise lower abdominal pain tender uterus subinvolution of the uterus purulent, foul-smelling lochia. light vaginal bleeding shock. RISK FACTORS Some women are more vulnerable to puerperal sepsis, including anaemia and/or malnourished, protracted labour, prolonged rupture of the membranes, frequent vaginal examinations, a traumatic delivery, caesarean section and retained placental fragments, PPH, diabetes all predispose to puerperal infection. SITES The most common site of infection in puerperal sepsis is the placental site. Other sites of infection are abdominal and perineal wounds following surgery and lacerations of the genital tract, e.g. cervix, vagina and perineum. Following delivery, puerperal sepsis may be localized in the perineum, vagina, cervix or uterus. Infection of the uterus can spread rapidly if due to virulent organisms, or if the mother's resistance is impaired. It can extend beyond the uterus to involve the fallopian tubes and ovaries, to the pelvic cellular tissue causing parametritis , to the pelvic peritoneum, causing peritonitis , and into the blood stream causing septicaemia DIFFERENTIAL DIAGNOSIS Fever in the puerperium can also be caused by: urinary tract infection (acute pyelonephritis) wound infection (e.g. scar of caesarean section) mastitis or breast abscess thrombo-embolic disorders, e.g. thrombophlebitis or deep vein thrombosis respiratory tract infections