Prevalence and outcome of puerperal sepsis among mothers in Nigeria: A five-year retrospective study

Background
Puerperal sepsis is one of the leading causes of maternal illness and mortality in low- and middle-income countries, despite advances in diagnosis, antimicrobial therapy, and medical management.

Aim
This study aimed to assess the prevalence and outcomes of puerperal sepsis in tertiary hospitals in Ondo State, Nigeria.

Methods
This retrospective cross-sectional study was conducted at a tertiary hospital in Ondo State. Total enumerative sampling was used to select patients diagnosed with puerperal sepsis between 2016 and 2020. An adapted structured checklist was used to retrieve data from patients’ medical records. Data analysis was performed using SPSS version 25. Descriptive and inferential statistics were used to analyze the results.

Findings
Out of 7980 obstetric cases managed during the study period, 156 patients had puerperal sepsis with a prevalence rate of 2%. The majority of patients were unregistered and were referred from other health facilities (94.2%). Other significant risk factors identified were postpartum hemorrhage (60.9%), prolonged labor (14.1%), premature rupture of membranes (19.9%), and lacerations (5.1%). Of the 156 patients diagnosed with puerperal sepsis, 151 (96.8%) were treated and discharged, while five (3.2%) died due to complications. Furthermore, a strong correlation was found between the mode of delivery and outcomes of puerperal sepsis (P ​= ​0.03).

Conclusions
Puerperal sepsis remains a major public health concern. Therefore, there is a need to promote prenatal care and ensure continuous supervision and monitoring of birthplaces/delivery centers in Nigeria.