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At least 19 recordsLinked to original sources
PubMed1991

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.

Adolescent↗
PubMed1986

[Puerperal infection].

Puerperal infections are of great importance also under the conditions of modern obstetrics. There is a close connection with the problematic nature of hospitalism. The prospective study from 1,409 patients shows a puerperal fever at a percentage of 32.1%. Only 19.0% of the patients meet the criteria of a "standard puerperal morbidity". Within the complications occurring during the childbed period subinvolutio uteri holds the first place with 16.3%. The incidence of puerperal infections is influenced by predisposing factors dominated by the mode of accouchement. Ampicillin and chloramphenicol are the most used antibiotics. The preventive and therapeutic application of antibiotics is discussed. In the experimental part of the study the settlement of the vagina, the cervix, and the amniotic fluid is analysed. The evidence of causative organism for oxybiontic pathogenes partly also for anoxybiontic pathogenes and fungi is made. The fight against puerperal infections is particularly based on preventive measures. There must be mentioned a strict consideration of the antisepsis and asepsis as well as the restriction of predisposing factors. Under this precondition the wellaimed and indicated application of a therapy based on antibiotics will be successful.

Anti-Bacterial Agents↗
PubMed1991

Maternal colonization by group B streptococci and puerperal infection; analysis of intrapartum chemoprophylaxis.

In a population of 1011 puerperal women, the significance of rectovaginal colonization by group B streptococci during pregnancy with respect to infective puerperal morbidity was analyzed. Patients who were found to be carriers during pregnancy (121) were randomly divided into two groups: women who received ampicillin during delivery (500 mg i.v./6 h) and patients without chemoprophylaxis. Compared with the non-carriers, the carrier patients without prophylaxis had a significant increase in the mild puerperal infective morbidity, when defined as the proportion of women with an index fever greater than or equal to 10 (10.6% vs. 25%). However, the increased incidence among the carrier women of premature rupture of the membranes and of other possible morbidity factors made it impossible to identify the role of group B streptococci. Mild puerperal infective morbidity in the carrier women who received prophylaxis was lower than in those without prophylaxis and very similar to that of non-carrier women. It is concluded that the use of chemoprophylaxis to prevent neonatal sepsis would probably be followed by a reduction in infectious puerperal morbidity.

Ampicillin↗
PubMed1991

Treatment of puerperal infection.

Ninety-two patients with puerperal infection admitted to Siriraj Hospital from April 1, 1980 to March 1, 1983 were studied. The treatment in this study was both medical and surgical, blood transfusion was given in some cases with low hematocrit level. The medical treatment alone was based on the causative organisms which were detected by cervical & intrauterine swab, smear & gram stain and cultures. PGS & Kanamycin were the most frequently used antibiotics which were intended to treat both gram-positive and gram-negative bacteria and adjunctive chloramphenicol for anaerobes. The surgical procedures which were performed in combination with medical treatment included total abdominal hysterectomy, uterine curettage, appendectomy and drainage of subdiaphragmatic abscess. The result of the treatment was satisfactory, 96.7 per cent improved after therapy with slight morbidity in some patients.

Anti-Bacterial Agents↗
PubMed1991

Computed tomography for evaluation of puerperal infections.

Pelvic computed tomography was used to evaluate 74 women with persistent puerperal infection. There was at least one abnormal roentgenographic finding in 57, and these are correlated with clinical and surgical findings. In 16 women, a palpable pelvic mass was seen on tomography, however, masses not appreciated clinically were visualized in another 29 women, and in five, a clinically palpable mass was not visualized by tomography. In 12 women who had a normal pelvic examination, septic pelvic thrombophlebitis was diagnosed by tomography. Over-all, there was poor correlation with roentgenographic findings and uterine incisional necrosis and dehiscence. We conclude that pelvic tomography is useful to evaluate some women with persistent puerperal infection, but that these studies must be correlated with clinical findings.

Adolescent↗
PubMed1976

Puerperal infection in the antibiotic era.

Developments in etiology and treatment of puerperal infection in the last 20 years are reviewed. Emphasis is placed upon predisposing factors, microbiology and antibiotics, unusual sources of severe infection, special complications, and prophylactic antibiotics.

Anti-Bacterial Agents↗
PubMed1978

Puerperal infection due to group A beta hemolytic streptococcus.

A cluster of 5 patients with puerperal infection due to group A beta hemolytic streptococcus (GABHS) is described. The most striking clinical signs included the early onset of uterine tenderness followed by an abrupt temperature elevation to greater than or equal to 102 F. At the time of uterine tenderness (Day 2, postpartum), 4 of 5 patients had gram-stained lochial smears showing a predominance of gram-positive cocci. The cluster of cases occurred with no source of the infection identified after 365 culture attempts. Therapy was rapidly successful with intravenous penicillin.

Cross Infection↗
PubMed1992

Life-threatening puerperal infection due to group A streptococci.

We describe two patients with life-threatening puerperal infection due to group A beta-hemolytic streptococcus. Each patient had bacteremia, shock, and multi-organ involvement. Both cases were compatible with a recently described streptococcal toxic shock-like illness. Both women failed to improve despite vigorous medical and antibiotic therapies, and each required hysterectomy. Obstetricians should be alert to the importance of early diagnosis and treatment of this potentially lethal infection.

Adult↗
PubMed1991

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.

Blood↗
PubMed1987

Moxalactam versus clindamycin plus tobramycin for the treatment of puerperal infections.

Sixty women with the diagnosis of puerperal endometritis were randomized to receive either moxalactam (n = 29) or the combination of clindamycin and tobramycin (n = 31) as therapy for their infection. Endometrial bacteriology consisted of mixed flora, both aerobic and anaerobic gram-positive and gram-negative organisms. Clinical cure was achieved in 27 (93%) of the moxalactam-treated patients and 28 (90%) of those given combination therapy. The two failures of moxalactam therapy were associated with enterococcal infection. Failures of clindamycin/tobramycin therapy were due to enterococcal infection, abscess formation, and moderately severe diarrhea. This study indicates that moxalactam is as effective and safe as the combination of clindamycin/tobramycin for the treatment of postpartum endometritis.

Clindamycin↗
PubMed1977

Fosfomycin in puerperal infections and its elimination in lochia.

31 patients suffering from puerperal endometritis, 16 of whom with other concomitant infections (sepsis, infection of episiotomy, pyelonephritis) were treated with fosfomycin. 86% of the germs isolated were sensitive to fosfomycin. The results obtained have been excellent in 26 patients (84%) and null in 5 (16%). Fosfomycin showed to be an antibiotic of wide-spectrum, and it acted very rapidly, since apirexia of the patients was achieved after 2-3 days of treatment. The antibiotic had perfect tolerance. No disagreeable secondary effects nor changes in the haematological data were observed. We have also carried out a study on the elimination in lochia of fosfomycin in a group of 21 patients with normal birth and puerperium. The concentrations of the antibiotic in lochia, although variable, are sufficient to achieve the desired bactericide action.

Anti-Bacterial Agents↗