Comparative Study on Incidence of Puerperal Sepsis in Hospital and Home Delivery at Bhaktapur District

Abstract

Background: Incidence of puerperal sepsis is expected to be very high in Nepal because of women do not have safe place to deliver their babies. In Nepal, only 6-10% of women get facility to give birth to their babies in the hospital which is considered to be the safe place for delivery. Delivery in other places is considered unsafe because most of the deliveries are conducted by unqualified persons such as sudenies/mother-in-laws. They are experienced but not scientifically trained to attend the deliveries. Due to lack of knowledge on cleanliness and hygiene of mother and the baby, the delivery may not be safe. Consequences of this will fall on the mother and new born baby. Thus majority of cases suffer from puerperal sepsis and often resulted to death. This study therefore was conducted to identify the incidence of puerperal sepsis in hospital and home delivery and to find out the contributing factors. Methods: This study was carried out at Bhaktapur hospital and rural community of the Bhaktapur district. The targeted population was the postnatal mothers within 15 days of delivery. A total of 500 respondents were included in the study. Semi-structured questionnaire was designed to collect information from the respondents. In order to obtain the sign and symptoms of puerperal sepsis, certain clinical instruments like clinical thermometer and measuring tape were used to measure involution of uterus. Results: The incidence of sepsis showed higher in percentage in home delivery (8%) and comparatively lower in hospital delivery (6.5%). Majority of women with developed sepsis were in age group of 20-24 years in both group. Evidence of sepsis was common in primiparous in hospital and multiparous women in home delivery. As the duration of labour becomes longer the evidence of sepsis showed higher in percentage in both home and hospital delivery cases. In terms of delivery attendants by the persons in home delivery, the study showed that the deliveries attended by untrained person were more likely to develop sepsis than the delivery attended by the trained person. Conclusions: Puerperal sepsis study should be conducted at remote areas. Keywords: home delivery; hospital delivery; incidence; postnatal mothers; puerperal sepsis.