From September 1993 to March 1995 a prospective, descriptive study was performed at Obstetrical Department of the General Hospital 2A the Mexican Institute of Social Security. An attempt to know the real
puerperal infection incidence in our own hospital to be able to make hypothesis and take specific measures in
puerperal infection control. Dairy account of interesting data of cases under inclusion criteria. Entering data in personal computer. Graphics and analysis were accomplished using Lotus 123, Statgraphics, EPI-6 of CDC and Freelance computational programs. Search of central tendency measures were performed, (media, median, mode, standard deviation). Odds ratio and relative risk were calculated, including hospitalization time and its temporary variation to data cross. X square and pi were including hospitalization time and its temporary variation to data cross. X square and pi were determined to statistic validates. The cumulated rate of general
puerperal infection were 1.2%. By stratification, the cumulated rate of
infection after
cesarean section, vaginal delivery and
miscarriage were 5.4%, 0.8% and 0.3%, respectively. There was predominance of
infection after
cesarean section, over
infection after vaginal delivery and after
miscarriage. (monthly media of 24.6, 7.3 and 0.47, respectively). The
puerperal infection was present principally in primiparous and in patients with one previous
cesarean section. The patients in which the termination of pregnancy was by
cesarean section, (0.015
infection cumulated incidence), had an
infection risk 5.76 and 18.66 times greater than the patients with vaginal delivery and
miscarriage. (Relative risk of 6.76 and 19.66) The site of
puerperal infection was implicated in combinations or isolated, under nine clinical situation. The five most frequent clinical situation, between these nine, in incidence order from major to minor were the following:
Endometritis alone,
Endometritis combined with
wound abscess.
Endometritis with urinary
infection, complicated
endometritis, (sub vesical
abscess,
parametritis,
peritonitis,
salpingitis), and
wound abscess alone). The greater hospitalization time was present in cases of complicated
endometritis followed by
wound abscess alone or combined. Complicated
endometritis, (incidence 0.0010), compel us to
hysterectomy in 15 cases. No death was registered among the patients with
puerperal infection studied.