Genital tract infection

Genital tract infection continues to present a life-threatening problem to women and Table 10.4 shows the risk of puerperal sepsis and maternal death over the last 17 years. The most virulent organism is beta-haemolytic streptococcus but more commonly Chalmydia, Escherichia coli and other gram negative bacteria will be the infective agents. Table 10.5 summarizes the main causes of post-natal pyrexia. Early diagnosis and treatment are

Table 10.4 Deaths from puerperal sepsis as reported in Confidential Enquiry into Maternal and Child Health

Triennium

Total deaths

Rate/million

Post-natal

Rate/million

1985-87

9

4

2

0.9

1988-90

17

7.2

4

1.7

1991-93

15

6.5

4

1.7

1994-96

16

7.3

11

5.0

1997-99

18

8.5

4

1.9

2000-02

13

6.5

5

2.5

Table 10.5 Risk factors for post-natal depression

Unmarried Under age 20

Brought up by single parent Poor parental support in childhood Poor relationship with partner Socially disadvantaged Poor achievement educationally Low self-esteem Previous emotional problems Previous depressive illness imperative if the long-term sequelae are to be avoided. Of importance in the five deaths that occurred between 2000 and 2002, four out of the five became ill in the community and it is important that healthcare professionals who are caring for women after discharge from hospital should be aware of the dangers of puerperal sepsis and the need for early treatment.

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