Information From Your Health Care Provider

PUERPERAL INFECTION

(Puerperal Fever; Postpartum Infection)

Basic information

description

Puerperal infection is a bacterial infection following delivery of a baby. The infection most often occurs in the uterus and causes inflammation (endometritis). It can also affect the vagina, vulva, perineum (area between the vagina and rectum), cervix, or peritoneum (membrane that covers abdominal organs).

FREQUENT SIGNS & SYMPTOMS

Fever and chills for two or more days after the first postpartum day (first day after delivery).
Headache and muscle aches.
Appetite loss.
Vaginal discharge with a foul odor.
Stomach (abdominal) pain.
General ill feeling.

causes

Infection by bacteria normally found in a healthy vagina. These bacteria can infect the uterus, vagina, adjacent tissues, and kidney.

risk increases with

Cesarean delivery.
Genital or urinary tract infection prior to delivery.
Use of a fetal scalp electrode during labor.
Anemia, either before pregnancy, or from loss of blood during delivery.
Poor nutrition during pregnancy.
Long delay between water break (rupture of the placental membranes) and delivery (more than 24 hours).
A small part of the placenta is left in the uterus.
Extra-long labor.
Multiple vaginal exams.
Obesity.
Diabetes.

PREVENTIVE MEASURES

No specific preventive steps. To reduce risk factors:
- Avoid anyone with an active infection for the last 2 weeks of pregnancy.
- Notify your obstetric provider as soon as your water breaks. Don't have sexual intercourse after this occurs.
- Wash the genital area often during the first week after delivery.

expected outcomes

Usually curable in 7 to 10 days with treatment.

possible complications

Deep-vein blood clot in the pelvis or pelvic abscess.
Shock.
Scarring.
Infertility.
Blood poisoning (although rare, could be fatal).

diagnosis & treatment

general measures

Your health care provider will do a physical exam including a pelvic exam. Medical tests may include blood and urine studies and studies of the vaginal discharge. Other tests may be done if drug treatment fails.
Treatment usually involves antibiotics for the infection. Hospital care may be needed for severe infection.
To relieve pain, place a heating pad or hot-water bottle on the abdomen or back. Take frequent, warm baths to relax muscles and help relieve pain.
Use sanitary pads, rather than tampons, for the vaginal discharge.
Surgery may be done to remove fragments of placenta or to treat an abscess or blood clot. An infected episiotomy (incision made during delivery) may need to be opened and drained.
If you breast-feed, ask your health care provider about continuing to do so during treatment.

medications

One or more antibiotics for infection will be prescribed. They may be taken by mouth or given through a vein (IV).
Drugs to reduce fever and relieve pain may be prescribed.
Anticoagulants may be prescribed to prevent blood clots from forming.

activity

Rest in bed, except to use the bathroom, until fever and other signs of infection clear up. You will probably be more comfortable if you lie on your left side.
Abstain from sexual relations until signs of infection have been gone for 7 days.

diet

Drink lots of fluids to prevent dehydration.

notify our office if

You or a family member has symptoms of a puerperal infection, even several hours after delivery.
Symptoms of infection recur after treatment.