Mst. Fancy Khatun
The puerperium or postpartum period generally lasts 6 weeks & is the period of adjustment after delivery when the anatomic & physiologic changes of pregnancy are reversed & the body returns to the normal approximately non pregnant state. Though it is a time of great importance for both mother and her baby, yet this aspect of maternity care has received less attention than pregnancy and delivery. A prospective study was conducted in Uttara Adhunic Medical College Hospital taking 300 patients in early puerperium excluding first 24 hours who underwent caesarean section. Most of the study patients belonged to 21-30 years of age, were parous, coming from low socio-economic condition having no or irregular antenatal checkup. In this study the incidence of early puerperal morbidities have been found to be high (40%), majority (55%) of cases belonged in 21-30 years of age, were parous (90%), coming from low socio-economic condition having no or irregular antenatal checkup (95%). Early puerperal morbidities like wound infection (50%), endomyometritis (45%) and UTI (35%) were observed more frequently among patients with the obstructed labour (40%), prolonged labour (30%), prolonged ruptured membrane (20%) and chorioamnionitis (10%).Many patients had more than one morbidities. Primary prevention for the most part should occur during labour and delivery or even earlier (pre pregnancy and antenatal care).Many of the complications cannot be predicted accurately or prevented. Hospital delivery for high risk pregnancy, supervision of each labour by skilled personnel, judicious use of oxytocin or prostaglandin or other uterine stimulant can prevent a considerable proportion of postpartum morbidities and mortalities. Use of partograph can prevent prolonged labour, obstructed labour that are associated with an increased risk of haemorrhage, sepsis, death and long term morbidities to those who survive. It is surprising that postpartum care has received so little attention compared with antenatal and intra partum care. The long term sequale of early puerperal infections morbidities should not be neglected as this may interfere the quality of a woman by infertility, ectopic pregnancy, chronic pelvic pain, dyspareunia etc. We believe that safe motherhood programmed should not neglect this crucial period.
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