An Evaluation of Postnatal Patients for Puerperal Pyrexia

Background: Puerperal pyrexia remains an important cause of maternal morbidity and mortality, particularly in developing countries. Early identification of its risk factors and etiologies is essential for timely intervention and improved maternal outcomes.Objectives: To evaluate the etiological factors, predisposing risk factors, maternal morbidity, mortality, and preventive measures associated with puerperal pyrexia among postnatal women in a tertiary care centre.

Methods: This observational study was conducted over 18 months (August 2022 to February 2024) in the Department of Obstetrics and Gynaecology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli. A total of 164 postnatal women with puerperal pyrexia were enrolled using convenience sampling. Demographic characteristics, obstetric variables, risk factors, etiologies, and maternal outcomes were recorded and analysed using Epi Info version 7.2.6.0. Statistical analysis included descriptive statistics, Chi-square test, and Student's t-test, with p<0.05 considered statistically significant.

Results: The prevalence of puerperal pyrexia was 16.4%. Most women were aged 20–29 years (50.0%) and were multiparous (46.95%). Lower segment caesarean section was the predominant mode of delivery (57.93%). Mastitis was the most common cause of puerperal pyrexia (25.61%), followed by urinary tract infection (12.80%) and septic thrombophlebitis (12.80%). Anaemia was present in 43.9%, gestational diabetes mellitus in 21.34%, pregnancy-induced hypertension in 39.63%, and immunocompromised status in 18.9% of women. Significant associations with maternal complications were observed for maternal age, PROM/PPROM, place and mode of delivery, gestational diabetes, and immunocompromised status. Sepsis occurred in 3.66% of patients, while the mortality rate was 1.22%.

Conclusion: Puerperal pyrexia continues to be a significant contributor to postpartum morbidity. Caesarean delivery, PROM/PPROM, gestational diabetes, immunocompromised status, and maternal age were important determinants of adverse outcomes. Early diagnosis, strict aseptic obstetric practices, optimal antenatal care, and prompt management of postpartum infections are essential to reduce maternal complications and mortality