slide purperal sepsis 5

8/13/2019 Slide Purperal Sepsis 5

1/16

T h e G l o b a l I n c i d e n c e o fP u e r p e r a l S e p s i s

P r o t o c o l f o r a S y s t e m a t i c R e v i e w

Dr MC ChisembeleTutor: Dr L SayWHO/GFMER/IAMANEH

Postgraduate Training Course in Reproductive HealthGeneva 2004


2/16

Outline

Background

Objective

Methods


3/16

Background

Sepsis is among the leading causes ofpreventable maternal death not only indeveloping countries but in developed

countries as wellIt is usually reported as the third or fourth

leading cause of maternal death


4/16

Background

The predisposing factors orconditions leading to thedevelopment of sepsisare quite varied andinclude:

Home birth in unhygienicconditions

Low socioeconomicstatus

Anaemia

PrimiparityProlonged rupture ofmembranesProlonged labour

Multiple vaginalexaminationsObstetrical manoeuvres


5/16

Background

Sepsis is an important morbid conditionbecause of its consequences on bothfetal and maternal outcomes


6/16

Background

Maternal complicationsinclude:Septicaemia,

Endotoxic shock,Peritonitis orabscess formationleading to surgeryLong term future

fertility

Fetal outcomes include

A depressed five-

minute Apgar score,Neonatalsepticaemia andPnuemonia


7/16

Background

Definition

'A temperature rise above 38.0 oCmaintained over 24 hours or recurring

during the period from the end of the 1st

to the end of the10 th day after childbirthor abortion'. (ICD-10)'Oral temperature of 38.0 oC or more onany two of the first ten days postpartum'.(USJCMW)


8/16

Background

There is some overlap with the definitionof endometritis in others whichincludes foul smelling discharge, uterinetenderness


9/16

Background

Incidence of puerperal sepsis showswide variations among publishedliterature may be related to definition,recording etc


10/16

Background

Sepsis is an important public healthproblem contributing to maternalmorbidity and mortality

Most of the predisposing factors arepreventableThe global magnitude of the problem islimited hence the need for a systematicreview summarizing the true extent ofpuerperal sepsis


11/16

Objective

To provide the incidence or prevalencedata on puerperal sepsis worldwide


12/16

Methods

Types of Studies Any study design including cross-sectional, cohort, clinical trials, surveyshaving incidence or prevalence data onpuerperal sepsis

Types of participantsWomen within 42 days of termination ofpregnancy


13/16

Methods

Types of interventionsNone

Types of outcome measuresPuerperal sepsis


14/16

Methods

Search strategyData bases Medline, EConlit, Biosis,EMBASE, Popline, Cinahl, Pias International,CAB, Sociofile, the gray literature database(SIGLE), Cochrane data basesHand searching of journalsPersonal contacts

Will review both published and unpublished data

from 1997-2002


15/16

MethodsSelection Criteria

Study designs providing prevalence orincidence rates for any puerperal sepsis in anypopulation

Exclusion CriteriaStudies with no dataReports providing statements only but nosource of dataReports referring to data collected before 1990Studies where no dates for data collection areprovided


16/16

Methods

Methods of Review All studies identified will be assessed by titlesand abstracts firstFull text retrieval

A data extraction form will be used to extractinformation such as design, population settingcharacteristics, follow-up, and completeness ofdataThe review is expected to be completed by theend of the year.

slide purperal sepsis 5

Documents