Epidemiological, Clinical, Therapeutic and Prognostic Aspects of Puerperal Infections within the Gynecology Obstetrics Department of Yalgado Ouedraogo University Teaching Hospital (CHU-YO), Burkina Faso

Objective: Conduct a study about the epidemiological, clinical, therapeutic and prognostic aspects of puerperal infections within Gynecology Obstetrics department of CHU-YO during the study period. Patients and Methods: This was a cross-sectional and descriptive study. The study period was from January 1st to December 31st, 2019. Data collection was retrospective. The exhaustive sample included all female patients having a puerperal infection. Results: Our study included 65 patients. The frequency of puerperal infections represented 1% of deliveries, the average age of patients was 27 ± 7.26 years. Housewives represented 64.4% of the patients. Hyperthermia and abdominal-pelvic pain respectively occurred in 63.8% and 21.3% of patients. The patients had given birth by caesarean section in 83.1% of cases. Endometritis represented 76.9% of cases of puerperal infections. The patients were treated with antibiotics, uterotonics and symptomatic therapy. Maternal death occurred in 13.9% of cases. Conclusion: A focus should be put on preventive measures in front of any high-risk puerperal infection situation.

Evaluation of Puerperal and Postpartum Infections after Cesarean Section and Their Clinical Outcomes

Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% - 15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.

Safety of Internal Electronic Fetal Heart Rate Monitoring During Labor

Objective:To investigate the safety and efficacy of internal electronic fetal heart rate(FHR)monitoring during labor.Methods:This was a retrospective case-control study,which was an analysis of monitoring FHR with a fetal scalp electrode or a Doppler probe(94 pregnant women per group).In the internal monitoring group,when the opening of the uterine orifice was≥3 cm,the fetal scalp electrode was placed after natural or artificial rupture of the membrane.FHR was simultaneously monitored using a Doppler probe.In the external monitoring group,continuous FHR monitoring was performed using an ultrasound Doppler transducer fixed on the maternal abdomen.The toco transducer was used to record uterine contractions.Pathological examination of the placenta was performed prospectively in 49 and 48 cases in the internal electronic FHR monitoring group and control group,respectively.Maternal-infant outcomes(e.g.fever,puerperal infection,puerperal morbidity,delivery mode,Apgar score,and scalp injury)were recorded.Umbilical artery blood was extracted for blood gas analysis.Differences between the two groups were compared using the pairedt-test,χ^(2) test,Yates correctedχ^(2) test or Fisher exact test.Results:Non-statistically significant differences between the internal and external monitoring groups were observed in the incidence of neonatal acidosis(1/94(1.06%)vs.3/94(3.19%),respectively;χ^(2)=0.255,P=0.613),cesarean section/operative vaginal delivery(8/94(8.51%)vs.15/94(15.96%),respectively;χ^(2)=2.427,P=0.181),fever during labor(18/94(19.15%)vs.15/94(15.96%),respectively;χ^(2)=0.331,P=0.565),puerperal morbidity(2/94(2.13%)vs.3/94(3.19%),respectively;χ^(2)=0.000,P=1.000),chorioamnionitis(9/49(18.37%)vs.7/48(14.58%),respectively;χ^(2)=0.252,P=0.616),and neonatal asphyxia(0/94(0.00%)vs.1/94(1.06%),respectively;χ^(2)=0.000,P=1.000).There were no puerperal infections,neonatal scalp injuries,or scalp abscesses found in either group.Using the internal monitoring value as reference,the incidence of FHR false deceleration in external FHR monitoring was 20.21%(19/94 women).Conclusion:Internal FHR monitoring during labor does not increase the incidence of adverse perinatal outcomes.External monitoring was associated with FHR false decelerations.