Gas gangrene in pregnancy, parturition, and abortions requiring urological and surgical intervention: aetiopathogenesis, risk factors, and some current practices
1 Department of Surgery, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.
2 Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria.
Research Article
Magna Scientia Advanced Research and Reviews, 2023, 07(02), 011–022
Article DOI: 10.30574/msarr.2023.7.2.0031
Publication history:
Received on 15 January 2023; revised on 01 March 2023; accepted on 03 March 2023
Abstract:
Introduction: Gas gangrene in pregnancy, perinatal periods, or after an abortion has a poor prognosis. This study aims to present risk factors for the disease as reported worldwide and to discuss current concepts of its aetiopathogenesis.
Materials and Methods: Using search terms, a bibliographical search was done in PubMed/ Medline and PubMed Central databases for publications on gas gangrene in pregnancy, abortions, and delivery published within the study period. Risk factors for the disease were identified by studying each of the reports. Results were presented with a discussion of the aetiopathogenesis of the disease.
Results: Eighty-one (81) studies reporting on 67 patients and aetiopathogenesis of the disease were studied. The most common causes of the disease were clostridia which infected 63 (94.03%) of the patients. Identified risk factors were abortions, prolonged labor, prolonged obstructed labor, standard spontaneous vaginal delivery, Cesarean sections, episiotomy, amniocentesis, cordocentesis, ruptured uterus with fetal death, perforated appendix, pelvic tumors, trauma, foreign bodies in living tissues, accumulation of hematoma and devitalized tissues in pelvic tissues. Lethal effects of the pathogens were reported to be mediated by exotoxins produced by clostridia.
Conclusion and Recommendations: Common risk factors are standard diagnostic and therapeutic procedures in pregnancy and its outcome. Local policies need to be developed for the extended use of antibiotics in normal labor and when carrying out procedures in pregnancy, delivery, and abortions. Attractive points in the aetiopathogenesis for the prevention of the disease are (i) prevention of attachment of clostridia to tissue cells and (ii) pre-pregnancy immunization of women of childbearing age.
Keywords:
Gas gangrene in pregnancy; Delivery and abortions; Aetiopathogenesis; Risk factors
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Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0