Maternal Mortality and Morbidity Caused by Puerperal Sepsis at Omdurman Maternity Hospital (OMH), Sudan 2017

Background: Puerperal sepsis is a life threatening condition triggered by infection. It is a common cause of maternal mortality and morbidity and the third direct cause of maternal death in Sudan. Objectives: To study maternal mortality and morbidity from puerperal sepsis and to indentify its associated risk factors at Omdurman maternity hospital (OMH) 2017 Methodology: This is a descriptive observational, cohort, hospital based study, conducted at (OMH), during 2017. All women who delivered or admitted to OMH during puerperium and diagnosed as puerperal sepsis were included in the study after an informed consent. Data was collected by trained data collectors using a structured format. Included variables were; detailed history and examination, socio- demographic characteristics, obstetric profile, management received, admission to intensive care unit (ICU) and maternal mortality and morbidity. Data was analyzed using SPSS version 21. Results: During the study period, a total of 36204 deliveries were reported, 25813 (71.3 %) were vaginal deliveries and 10391 (28.7 %) were cesarean section (C/S). Out of them, 133 were diagnosed as puerperal sepsis, 60 (45.1 %) delivered vaginally and 73 (54.9 %) by C/S. Rate of puerperal sepsis in this hospital was 0.37 %, o.23 % for vaginal delivery and 0.7 % for C/S. Common risk factors were; repeated vaginal examination 35 (26.3 %), prolonged labour 30 (22.6 %) and prolonged rupture of membranes 23 (17.3 %). Frequently associated with middle age (21-30 years) 71 (53.4 %), multiparity 61 (45.9 %), illiteracy 48 (36.1 %) and rural residence 81 (60.9 %). Mostly presented with; fever 77 (57.9 %), foul smelly vaginal discharge 31 (23.3 %) and abdominal pain 12 (09.0 %). Thirty six (42.4 %) developed septicemia, 28 (21.0 %) were admitted to intensive care unit (ICU) and nine died, with fatality rate of 6.8 %. Conclusion: Puerperal sepsis is a common preventable public health problem, with high maternal mortality. Main risk factors are related to child