Puerperal tetanus and hysterectomy.

OBJECTIVES

To compare the clinical course and outcome of patients with post-partum tetanus (n = 21) to those of non-post-partum ones (n = 24) and to determine the effect of early hysterectomy on the survival of cases with severe post-partum tetanus (n = 20).

METHODS

In this prospective study we compared the clinical course and outcome of post-partum and non-post-partum cases of tetanus admitted to the intensive care unit. Moreover, early hysterectomy was done on every other patient with severe post-partum tetanus (n = 10). Chi-square and Student's t-tests were used for statistical purposes.

RESULTS

Post-partum cases were younger (P = 0.002), had a higher incidence of acute respiratory failure and a mortality rate compared to the non-post-partum group. In addition, early hysterectomy did not change the course of severe post-partum cases.

CONCLUSION

The mortality associated with post-partum tetanus is comparable to non-post-partum cases and early hysterectomy has no effect on its outcome.