International Journal of Advances in Medicine | May-June 2018 | Vol 5 | Issue 3 Page 525 International Journal of Advances in Medicine Sharma SS et al. Int J Adv Med. 2018 Jun;5(3):525-529 http://www.ijmedicine.com pISSN 2349-3925 | eISSN 2349-3933 Original Research Article Medical complications of puerperium: a single center observational study Shiv Shankar Sharma 1 , Somen Bhattacharjee 2 *, Archana Kashyap 2 , Ashok Thakur 1 , Sanjay Dubey 1 ABSTRACT Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non-pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies. Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks. Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%. Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications. Keywords: Depression, Puerperium, Pyrexia, Puerperal-sepsis 1 Department of Medicine, 2 Department of Obstetrics and Gynaecology, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India Received: 09 April 2018 Accepted: 13 April 2018 *Correspondence: Dr. Somen Bhattacharjee, E-mail: drsomenmd@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-3933.ijam20181662