Factors affecting postpartum infection: A systematic review

Background: Puerperal infection is used to describe any bacterial infection of the reproductive tract after delivery. Identifying the factors affecting postpartum infections can reduce the risk and complications of such factors and postpartum maternal mortality. Objective: This structured study was designed to evaluate factors affecting postpartum infections. Methods: In this study, after selecting Scopus, PubMed, SID, and Web of Science electronic databases, all observational studies (cohort and case-control) available and published in Farsi and English to investigate factors affecting postpartum infections were searched. The search was performed using the terms postpartum, infection, wound infection, puerperium, reason, risk factor, and their equivalent Persian words from 2010 to November 2019 regardless of publication status. Results: Out of the 3227 studies obtained, 19 were reviewed after removing irrelevant articles, duplicates (shared in databases), and animal samples. Age, level of education, delivery method, presence of episiotomy, anemia due to postpartum hemorrhage, interventions and manipulations during childbirth, prenatal hygiene, Povidone Iodine usage before delivery to wash the vagina, antibiotic prevention, increased labor duration, obesity, and the presence of bacteria were common symptoms affecting postpartum infection. Conclusion: In this study, the factors affecting postpartum infection have been identified, some of which are avoidable. Identifying these factors helps reduce postpartum infections and their complications.

Invivo Effect Analysis of Rhodomyrtus tomentosa Leaf Ethanol Extract Against Escherichia coli

Puerperium infection contributed 11 percent of 48.17 percent of maternal mortality during the puerperium period; one of the causes of increased risk of puerperium infection was bacteria Gram-negative Escherichia coli. Puerperium infection occurred because bacteria enter through the vagina, wounds on the insertion of the placenta, and other parts spread to blood throughout the body and damage the spleen, liver, and uterus. This research aimed to determine the effect of Rhodomyrtus tomentosa leaves ethanol extract (Rtl-EE) as an antibacterial on the spleen, liver, and uterus of Escherichia coli -induced puerperal infection model mice. Mice in the postnatal treatment group were induced by Escherichia coli bacteria intravaginally and given different doses of ethanol extract of Rhodomyrtus tomentosa leaves. Examination of bacterial colonies growth used pour plate method with EMBA media. The research results showed that the administration of Rtl-EE decreased the growth of bacterial colonies respectively in the liver 1280, 924, 330 CFU/mL; the uterus 1806, 1180, 874 CFU/mL; and the spleen 712, 112, 774 CFU/mL. Colony growth started to decrease at dose 1 of Rtl-EE (100mg/kg BW) of mice model of Escherichia coli -induced puerperal infection. Rhodomyrtus tomentosa leaves contain active compounds - phenols, flavonoids, saponins, tannins, alkaloids, and triterpenoids as antibacterial. Rtl-EE had an antibacterial effect by reducing the number of bacteria on the spleen, liver, and uterus of Escherichia coli -induced puerperal infection model mice. Further research needs to conduct to examine the toxic dose of Rhodomyrtus tomentosa leaves against Escherichia coli bacteria.

Identification and Management of High Risk Complications during Postnatal Period by Ground Level Workers

What to expect after the child birth. A healthy newborn is considered as priority, but postnatal care counts too. It is not always that story ended up with safe child birth; mother is still at high risk if not taken care after birth. Antenatal and intra natal period are the hardest part of a life span of a pregnant women. Mandatory Antenatal visits and maternal and child health services provided by the government with hand holding national programs and schemes have converted this tough path into smooth platform. Similarly postnatal period is equally important in the life of a new mother. The transition has already been set up by creating fourth stage of pregnancy instead of traditional three stages. Several studies have observed complications in postnatal period especially Primary PPH but very minimal studies had concentrated on Secondary PPH. Over and above there are no significant and standardized guidelines made available for the health workers to define the set limits of blood loss and management of secondary PPH. The condition becomes more critical when severe secondary PPH came for the hospitalization when the exact cause and associated factors remains often unknown. Also many postpartum infections emerge 24 hours after the delivery and discharge from hospital. Consequently, in the lack of proper knowledge and skills regarding identification of postnatal complications like secondary PPH and Puerperal infection, many cases go undiagnosed and unreported. This chapter will deals with the skills of the ground level workers required to identify and manage selected high risk complications in postnatal period.

Pemberian KIE Dengan Pengetahuan Ibu Nifas Mengenai Infeksi Masa Nifas Di Dusun Kelapa Dua

The puerperium begins after the placenta is born and ends when the uterus organs return to their pre-pregnancy state. The puerperium lasts about 6 weeks or 40 days but will recover completely within 3 months. The puerperium or postpartum period is also called puerperium which comes from the Latin word "puer" which means baby and "parous "which means giving birth. Based on data obtained according to recording and reporting from districts/cities, the maternal mortality rate (MMR / MMR) in Maluku Province fluctuated from 2006 to 2010. However, it decreased from 369 per 100,000 live births in 2006 to 288 per 100,000 births. live in 2010.Keywords: KIE, Knowledge, puerperal infection

Different Methods for Termination of Mid-trimester Pregnancy With Placenta Previa

Objective: Investigate the different methods for termination at mid-trimester in pregnant women with placenta previa. Methods: A retrospective study was conducted on 264 cases for termination at mid-pregnancy in our hospital, and 34 cases with placenta previa were set as the observation group, and 230 cases with normal placenta were set as control group. Among them, the preferred methods of termination at first were Mifepristone combined with Misoprostol/Rivanol in the observation group, and Mifepristone combined with Misoprostol/Rivanol/cervical double balloon (CDB) in the control group. If the volume of prenatal bleeding was up to 100 mL in the observation group, emergency artery embolization (UAE) was implemented to stop bleeding, then CDB plus with curettage were used in order. If it failed to induce in the control group, CDB was used subsequently followed with Misoprostol/Rivanol. Then, all those cases were set as the comprehensive-induce group, and the others were set as the simple-induce group.Results: the average maternal age, the number of gravidity/parities, the rate of cesarean section, the hospitalization days and cost, the induction time, the rate of postpartum hemorrhage, puerperal infection were higher in the observation group than those in the control group(p<0.05). There were 4 cases used UAE+CDB+curettage in the observation group and 6 cases used CDB after Misoprostol/Rivanol in the control group. The duration time of termination, the rate of postpartum hemorrhage and transferring to ICU, hospitalization days and cost in the comprehensive-induce group were significantly higher than those in the simple-induce group (p<0.05). All cases were delivered through vaginal successfully.Conclusion: We should pay more attention to the complications of prenatal bleeding, postpartum hemorrhage, puerperal infection during the induction at mid-trimester in pregnant women with placenta previa. Emergency UAE + CDB +curettage is a good combination method in prenatal hemorrhage of placenta previa during termination, and CDB was a good tool for cervical ripen with immature cervical condition in mid-trimester for induction of labor.

Antimicrobial Prophylaxis for Caesarean Delivery; A comparative study between different agents

Antimicrobial prophylaxis is commonly used for pre-intra and post-operative caesarean delivery. Caesarean delivery is still the single most important risk factor for puerperal infection. Post-caesarean infections include wound infections, endomyometritis, bacteraemia, septic shock, septic pelvic vein thrombophlebitis, necrotising fasciitis, pelvic abscess, dehiscence of the wound or evisceration. The goal of antimicrobial prophylaxis is to put a stop to postoperative infection of the surgical site, the use of therapeutic antibiotics, additional surgical interventions, longer duration of hospital stay, to decrease postoperative infectious morbidity and mortality and the cost of postoperative health care. A post-caesarean wound infection detected prior to hospital discharge will lead to prolongation of hospital stay and will increase the hospitalisation costs and need of readmission. Both the American College of Obstetricians and Gynaecologists and the American Society of Health-Care System Pharmacists have introduced single-dose prophylactic protocols using a heterogeneity of agents (penicillins, cephalosporins, clindamycin and azithromycin). Women undergoing caesarean delivery have a greater risk of developing infection compared to women who have a vaginal birth by 5 to 20-fold. The use of prophylaxis in patients undergoing a low-risk Caesarean Delivery remains controversial.

INNOVATION OF THE USE OF HONEY AS A TOPICAL MEDICINE TO THE THERAPY OF ABDOMEN'S INCISION POST-CAESAR

Honey has long been used as food and medicine. One of the many researched benefits of honey is that it speeds up wound healing. The Koran and the hadiths clearly state that there is healing in honey. Along with advances in technology, cesarean delivery is increasingly being performed to help facilitate labor under various indications. However, cesarean delivery can limit the mother's activities in the care of herself and her child. On the other hand, cesarean delivery also often causes obstetric complications such as puerperal infection, endometritis, wound complications, and surgical healing complications. It will increase the cost of cesarean delivery. The authors reviewed the data regarding the effectiveness of honey in the therapy of post-cesarean delivery abdominal incisions. The data show that the antibacterial, anti-inflammatory, and antioxidant characteristics of honey can significantly affect the therapy of cesarean delivery incisions. The combination of the osmotic effect and hydrogen peroxide activity in honey can inhibit bacterial growth, reduce edema, exudate, and pain due to inflammatory processes. Besides, honey has the effect of protecting antioxidant enzymes from free radicals and reducing oxidative stress to reduce cell damage. Honey can also stimulate angiogenesis, the proliferation of fibroblasts and epithelial cells, and granulation, helping speed up the healing process. This paper discusses honey's mechanism in accelerating wound healing and its effect in preventing wound infection from improving the quality of health and the relationship between mother and child after cesarean delivery.

Antistreptococcal serum

The author reports 3 cases of the use of antistreptococcal serum: in one 3-month-old child who suffered from erysipelas, in a woman with pharyngeal lesions (ang.pseudomembran, streptococci and in a puerperal woman in puerperal infection.