Puerperal Pyrexia: Causes and Risk Factors

Definition and Etiology

• Puerperal pyrexia, also known as childbed fever, is a serious and potentially life-threatening infection that occurs in women during the postpartum period, usually within the first 10 days after childbirth.
• Caused by bacterial infection, typically by group A streptococcus (GAS) or Escherichia coli (E. coli).
• Infection can occur through:
  • Contaminated medical equipment
  • Unclean hands of healthcare providers
  • Poor hygiene practices during delivery
  • Pre-existing infections in the mother

Risk Factors

• Cesarean section or instrumental delivery
• Prolonged rupture of membranes (>24 hours)
• Chorioamnionitis during pregnancy
• Diabetes or other underlying medical conditions
• Older maternal age
• Multiparity (having multiple births)

Symptoms and Diagnosis

• Elevated temperature (>38°C) within 10 days postpartum
• Chills, headache, and general malaise
• Abdominal pain, uterine tenderness, and foul-smelling lochia (postpartum vaginal discharge)
• Diagnosis based on clinical presentation, laboratory tests (blood cultures, complete blood count), and imaging studies (ultrasound, CT scan)

Complications and Management

• Sepsis, shock, and organ failure if left untreated
• Treatment involves antibiotics, fluid resuscitation, and supportive care
• In severe cases, surgical intervention may be necessary to drain abscesses or remove infected tissue
• Early recognition and prompt treatment crucial to prevent maternal mortality and morbidity

Definition and Etiology

• Puerperal pyrexia, also known as childbed fever, is a serious and potentially life-threatening infection that occurs in women during the postpartum period, usually within the first 10 days after childbirth.
• Caused by bacterial infection, typically by group A streptococcus (GAS) or Escherichia coli (E.coli).
• Infection can occur through contaminated medical equipment, unclean hands of healthcare providers, poor hygiene practices during delivery, or pre-existing infections in the mother.

Risk Factors

• Cesarean section or instrumental delivery increases the risk of puerperal pyrexia.
• Prolonged rupture of membranes (>24 hours) is a risk factor.
• Chorioamnionitis during pregnancy increases the risk of puerperal pyrexia.
• Diabetes or other underlying medical conditions are risk factors.
• Older maternal age is a risk factor.
• Multiparity (having multiple births) increases the risk of puerperal pyrexia.

Symptoms and Diagnosis

• Elevated temperature (>38°C) within 10 days postpartum is a symptom of puerperal pyrexia.
• Chills, headache, and general malaise are symptoms of puerperal pyrexia.
• Abdominal pain, uterine tenderness, and foul-smelling lochia (postpartum vaginal discharge) are symptoms of puerperal pyrexia.
• Diagnosis is based on clinical presentation, laboratory tests (blood cultures, complete blood count), and imaging studies (ultrasound, CT scan).

Complications and Management

• Sepsis, shock, and organ failure can occur if puerperal pyrexia is left untreated.
• Treatment involves antibiotics, fluid resuscitation, and supportive care.
• In severe cases, surgical intervention may be necessary to drain abscesses or remove infected tissue.
• Early recognition and prompt treatment are crucial to prevent maternal mortality and morbidity.