Open AccessIncidence, treatment and outcome of peripartum sepsis
Author(s) -
Kankuri Esko,
Kurki Tapio,
Carlson Petteri,
Hiilesmaa Vilho
Publication year - 2003
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1034/j.1600-0412.2003.00265.x
Subject(s) - medicine , sepsis , bacteremia , cefuroxime , incidence (geometry) , streptococcus agalactiae , cephalosporin , pregnancy , septic shock , staphylococcus aureus , neonatal sepsis , metronidazole , vaginal delivery , obstetrics , streptococcus , antibiotics , microbiology and biotechnology , bacteria , physics , optics , biology , genetics
Background and methods. Clinical and microbiological features of maternal sepsis in the peripartum period (7 days before to 7 days after delivery) were analyzed to determine possible risk factors, optimal treatment and outcome. In 43 483 deliveries during 1990–98, laboratory‐confirmed bacteremia was found in 41 (5.1%) out of 798 clinically suspected septic infections. Results. Preterm deliveries were associated with a crude 2.7‐fold risk for peripartum sepsis as compared to term deliveries. Antepartum sepsis was associated with a crude 2.6‐fold risk for cesarean section, while postpartum sepsis was 3.2 times more likely to occur after cesarean section than after vaginal delivery. A combination of cefuroxime and metronidazole was used in 80% (33/41) of all treatments. All mothers recovered well, and only one suffered from septic shock. In total, 42 bacterial strains, representing 18 different bacterial species, were isolated from the blood cultures; 37 strains (88%, 37/42) were aerobic and five (12%, 5/42) were anaerobic. The most common species were betahemolytic streptococci, Escherichia coli and Staphylococcus aureus . Most microbes (81%, 34/42) were found to be susceptible to first‐ or second‐generation cephalosporins. Conclusion. Our analysis shows that peripartum sepsis is associated with preterm pregnancies and cesarean sections. Treatment of peripartum sepsis with second‐generation cephalosporin is usually effective, and the outcome is good.