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Puerperal infections are bacterial infections that can occur after childbirth, usually in the birth canal but can spread to other parts of the body. Symptoms include fever and localized pain. Antibiotic therapy is the primary treatment, and surgery may be necessary in severe cases. Immediate medical attention is necessary to avoid fatal sepsis.
A puerperal infection is a bacterial infection that develops in a woman after giving birth. The infection usually occurs in the birth canal, but can spread to the uterus or other parts of the body, causing conditions such as pelvic and femoral thrombophlebitis or peritonitis. Although puerperal infections usually respond well to antibiotic therapy, the condition can be fatal.
Women who give birth by caesarean section are more prone to puerperal infections than women who give birth vaginally. Other factors predisposing to infection include a long period of labor, maternal bleeding, and an unsanitary delivery or unsanitary vaginal exams. Maternal health is also a factor. If the mother has poor nutrition or anemia, for example, she may be vulnerable to infection.
One of the first symptoms of a puerperal infection is a fever. A new mother who develops a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher for two consecutive days during the first 10 days after delivery should be evaluated by a doctor for the possibility of infection. However, not all postpartum fevers are caused by puerperal infections, so the patient’s doctor will also investigate other potential causes of the fever.
Other symptoms of puerperal infections, other than the onset of fever, vary depending on where the infection is located in the body. Symptoms of a genital tract infection, for example, can include vaginal discharge, discomfort, and abdominal pain. Localized lesions may also be observed at the site of infection. If the infection occurs in the lining of the uterus, which is a condition known as enteritis, symptoms can include foul-smelling lochia, back pain, and painful postpartum uterine contractions. Abdominal pain can occur with pelvic thrombophlebitis, and pain or swelling in the affected leg can occur with femoral thrombophlebitis.
To diagnose puerperal infection, a doctor will perform a pelvic exam and culture the infection to determine the specific organism causing the problem. Your doctor might also order blood tests. If a urinary tract infection is suspected, your doctor might order a urinalysis. If your doctor suspects a more serious problem such as an abscess or blood clot, computed tomography (CT) scans or magnetic resonance imaging (MRI) tests may be ordered.
Treatment for a puerperal infection begins with antibiotic therapy. Doctors who suspect puerperal fever in their patients might prescribe a broad-spectrum antibiotic to begin fighting pathogens and switch to another antibiotic specifically for the identified causative bacteria after the patient’s cultures and blood test results are known. If the infection progresses enough to cause an abscess, surgery may be needed to drain the wound.
Only a small percentage of women develop puerperal infections. The prognosis for this condition is good with antibiotic therapy. However, if the infection is not treated, fatal sepsis can develop, so it is important for women to seek immediate medical attention if they develop fever or other symptoms of infection after giving birth.
