How will you manage a case of puerperal sepsis ? D-06.07.08.09 J-11.12.

Managment of Puerperal sepsis :
Clinical features
Symptoms
1. Fever, 
2.generalized malaise
3.headache, 
4. The local wound becomes red and swollen
5.foul smellning per vaginal dicharge 
 Signs:
1.high rise of temperature, often with chills and rigor,
2. Pulse rate is rapid, out of proportion to temperature,
3.Often there is breathlessness, coughs, abdominal pain and dysuria, 
4. Lochia may be scanty and odorless
5.Uterus may be subinvoluted, tender and
softer.

Investigation:
Blood for TC DC ESR  HC% 
2.Usg of  Pelvic cavity 
3.Urine for R/M/E 
4.Culture of Blood 
 Treatment 
A.General care: (
1. Isolation of the patient
2Fluid maintained by intravenous infusion (IV),
3.Anemia is corrected by  blood transfusion,

4. Antibiotics:should be culture sensitivity 
Inj -Clindamycin
Inj - Cephradin 
Inj -Metranidazole
 
 B.Surgical Care
1.Perineal wound—The stitches of the perineal wound removed 
2.Pelvic abscess should be drained 
                                                   Ref by Dutta Page 500

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