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A puerperal infection is a bacterial infection that develops in a woman after childbirth. The infection usually occurs in the birth canal, but it can spread to the uterus or other parts of the body, causing such conditions as pelvic and femoral thrombophlebitis or peritonitis. Although puerperal infections usually respond well to antibiotic therapy, the condition can be fatal.
Women who deliver their babies by Caesarian section are more prone to puerperal infection than women who deliver vaginally. Other predisposing factors to infection include an extended period of labor, maternal hemorrhage and an unsanitary delivery or unsanitary vaginal examinations. Maternal health also is a factor. If the mother has poor nutrition or anemia, for example, she could 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 greater for two consecutive days during the first 10 days after giving birth should be evaluated by a physician for the possibility of infection. Not all postpartal fevers, though, are caused by puerperal infections, so the patient’s physician will also investigate other potential causes of the fever.
Other symptoms of puerperal infections, besides the onset of a fever, vary depending on the location of the infection in the body. Symptoms of a genital tract infection, for example, can include vaginal discharge, malaise and abdominal pain. Localized lesions might be seen at the site of the infection, too. If the infection arises in the lining of the uterus, which is a condition known as enteritis, then the symptoms can include foul-smelling lochia, backache 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 physician will perform a pelvic examination and will culture the infection to determine the specific organism causing the problem. The doctor might also order blood tests. If a urinary tract infection is suspected, the doctor might order a urinalysis. If the physician suspects a more serious problem such as an abscess or blood clot, computed tomography (CT) scans or magnetic resonance imagine (MRI) tests might be ordered.
Treatment for a puerperal infection begins with the antibiotic therapy. Physicians suspecting puerperal fever in their patients might prescribe a broad spectrum antibiotic to begin combating the pathogens and switch to another antibiotic specific to 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 might become necessary to drain the wound.
Only a small percentage of women develop puerperal infections. The prognosis for this condition is good with antibiotic therapy. A fatal sepsis can develop if the infection is untreated, though, so it’s important for women to seek immediate medical care if they develop a fever or other symptoms of infection after childbirth.