MBchB study guide

Apr 28th, 2015
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PUERPERAL SEPSIS (METRITIS)DefinitionAn infection of the genital tract at any time between the onset of rupture of membranes or labour and the 42nd day following delivery or abortionPuerperal sepsis is any bacterial infection of the genital tract which occurs after the birth of a baby. It is usually more than 24 hours after delivery before the symptoms and signs appear. If, however, the woman has had prolonged rupture of membranes or a prolonged labour without prophylactic antibiotics, then the disease may become evident earlierEtiologyBacteria which cause puerperal sepsisStreptococciStaphylococciEscherichia coli (E.coli)Clostridium tetaniClostridium welchiiChlamydiaGonococci (bacteria which cause sexually transmitted diseases)More than one type of bacteria may be involved when a woman develops puerperal sepsis.Bacteria may be either endogenous or exogenous.Endogenous bacteria: These are bacteria which normally live in the vagina and rectum without causing harm (e.g. some types of streptococci and staphylococci, E.coli, clostridium welchii).Even when a clean technique is used for delivery, infection can still occur from endogenous bacteria.Endogenous bacteria can become harmful and cause infection if:They are carried into the uterus, usually from the vagina, by the examining finger or by instruments during pelvic examinationsThere is tissue damage, i.e. bruised, lacerated or dead tissue (e.g. after a traumatic delivery or following obstructed labou

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