Archives of Gynecology and Obstetrics

, Volume 285, Issue 4, pp 913–917 | Cite as

Risk factors and microbial isolates of puerperal sepsis at the University of Maiduguri Teaching Hospital, Maiduguri, North-eastern Nigeria

  • Babagana BakoEmail author
  • Bala M. Audu
  • Zara Mairam Lawan
  • Jidda Baba Umar
Maternal-Fetal Medicine



To determine the risk factors and microbial isolates of puerperal sepsis.


A 12 year retrospective review of patients with puerperal sepsis from January 1999 to December 2010 at the University of Maiduguri Teaching Hospital (UMTH) was conducted. Information on socio-demographic characteristics, clinical presentations, place and mode of delivery and microorganism isolated from the endocervical swabs was collected and analysed. Comparison was also made with the other women that delivered during the period of study.


The incidence of puerperal sepsis was 0.78%. Majority (88.0%) of the patients were unbooked, 59.1% delivered at home and 23.1% delivered in other peripheral hospitals. The major risk factors for developing puerperal sepsis were unbooked status, home delivery, perineal trauma, caesarean section (C/S) and maternal age <24 years with OR of 56.60, 39.25, 8.52, 4.99 and 1.32, respectively. The commonest microorganism isolated were Staphylococcus aureus and Escherichia coli seen in 35.4 and 20.9%, respectively. Streptococcus species was found in 6.9%, while 20.3% had polymicrobials isolated.


Puerperal sepsis continues to present a significant risk of maternal mortality in developing countries. The risk factors are unbooked women, home delivery, perineal trauma, caesarean section and maternal age <24 years. S. aureus and E. coli are the commonest isolated organisms. There is a need to enlighten the populace on the need for booking, skilled attendant at delivery and hospital delivery under aseptic conditions.


Puerperal Sepsis Caesarean Perineal Trauma Mortality Polymicrobial 


Conflict of interest

No actual or potential conflict of interest in relation to this article exists.


  1. 1.
    Ekwempu CC Jr, Otubu JAM (2006) Abnormal puerperium. In: Akin Agboola (ed) Text book of obstetrics and gynaecology for medical student, chap 62. Heinemann, Lagos, pp 504–508Google Scholar
  2. 2.
    The prevention and management of puerperal sepsis, report of a technical working group. WHO/FHE/MSM/95.4. Geneva Wold Health Organisation, 1995Google Scholar
  3. 3.
    Mairiga AG, Kawuwa MD, Kyari O (2008) A fourteen year review of maternal mortality at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Niger Hosp Pract 2(5):115–119Google Scholar
  4. 4.
    FMOH. National HIV/AIDS and Reproductive Health Survey, 2007 (NARHS Plus). Federal Ministry of Health Abuja, 2008, pp 112–122Google Scholar
  5. 5.
    Chisembele M (2004) The global incidence of puerperal sepsis, Geneva foundation for medical education and research postgraduate training course in reproductive health (pp 477–479)Google Scholar
  6. 6.
    Poggi SBH (2007) Abnormal puerperium. In: Decharney AH, Nathan L, Goodwin JM, Laufer N (eds) Current diagnosis and treatment, chap 31. Mc Graw Hill, New York, pp 477–497Google Scholar
  7. 7.
    Smaill F, Hofmeyer GJ (2002) Antibiotic prophylaxis for caesarean section. Cochrane Database of systematic reviews, Issue 1Google Scholar
  8. 8.
    Dare FO, Bako AU, Ezechi OC (1998) Puerperal sepsis: a preventable postpartum complication. Trop Doctor 28:92–95Google Scholar
  9. 9.
    Dolea C, Stein C (2003) Global burden of maternal sepsis in the year 2000. Evidence and information for policy (EIP). World Health Organization, GenevaGoogle Scholar
  10. 10.
    Abouzahr C, Aaahman E, Guidotti R (1998) Puerperal sepsis and other puerperal infections. In: Murray CJL, Lopez AD (eds) Health dimensions of sex and reproduction: the global burden of sexually transmitted diseases, maternal conditions, perinatal disorders, and congenital anomalies. WHO, GenevaGoogle Scholar
  11. 11.
    Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case–control study. BMJ 322(7294):1089–1093PubMedCrossRefGoogle Scholar
  12. 12.
    Pradhan A (2005) Situation of antenatal care and delivery practices. Kathmandu Univ Med J 3(3):266–270Google Scholar
  13. 13.
    Brennan M (1989) Training traditional birth attendants. Postgrad Doctor 11:16Google Scholar
  14. 14.
    Brentlinger PE, Capps L (1998) Pregnancy outcomes in El Salvador during the post-war period. Int J Gynaecol Obstet 61:59–62PubMedCrossRefGoogle Scholar
  15. 15.
    van Dillen J, Zwart J, Schutte J, van Roosmalen J (2010) Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis 23:249–254PubMedCrossRefGoogle Scholar
  16. 16.
    Maharaj D, Teach DT (2007) Puerperal pyrexia: a review part 1. Obstet Gynaecol Survey 62(6):393–399CrossRefGoogle Scholar
  17. 17.
    Akerele J, Abhulimen P, Okonofua F (2002) Prevalence of asymptomatic genital infection among pregnant women in Benin city, Nigeria. Afr J Reprod Health 6(3):93–97PubMedCrossRefGoogle Scholar
  18. 18.
    Ekwempu CC, Lawande RV, Egler LY (1981) Microbial flora of lower genital tract of women in labour in Zaria, Nigeria. J Clin Pathol 34:82–83PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Babagana Bako
    • 1
    Email author
  • Bala M. Audu
    • 1
  • Zara Mairam Lawan
    • 1
  • Jidda Baba Umar
    • 2
  1. 1.Department of Obstetrics and GynaecologyUniversity of Maiduguri Teaching HospitalMaiduguriNigeria
  2. 2.Department of MicrobiologyUniversity of Maiduguri Teaching HospitalMaiduguriNigeria

Personalised recommendations