Risk factors in puerperal infection.

Puerperal infection is one of the most common obstetric complications which leads to certain serious sequelas for those parturients. The study of 92 postpartum women at Siriraj Hospital from April 1, 1980 to March 1, 1983 was conducted to investigate the risk factors of puerperal infection. All 92 cases were diagnosed for puerperal infection according to the criteria of the Joint Committee on Maternal Welfare. Irregular antenatal care or no antenatal care, sexual intercourse during the last week before delivery and pelvic examination during pregnancy were found to be important predisposing factors in the antepartum period. Pelvic examination during labor accounted for 78 per cent of the patients and played an important role, while operative obstetrics (30%) and concomitant diseases during pregnancy (27%) were the next significant factors.

Causative organisms in puerperal infection.

Ninety-two postpartum women who had been admitted to Siriraj Hospital from April 1, 1980 to March 1, 1983 were studied for the causative organisms of puerperal infection. Cervical and intrauterine swab & smear-gram stain as well as cultures were performed. Hemocultures were done in some cases. Only 50 per cent of all cases had positive cervical and intrauterine swab smears which showed different kinds of micro-organisms, 78 per cent were gram-positive cocci, gram-negative rod was found in 4 specimens, 2 specimens of gonococcal smears, one for trichomonads. Cervical and intrauterine swab cultures were positive in only 31.5 per cent. E. Coli was the most common and Staphylococci & Streptococci were the second most common.