Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Puerperalfever is a term that was used in the early 18th century to describe what we today call a postpartum infection.Postpartum infection is abacterial infectionof the reproductive organs that occurs up to 10 days after a pregnant person gives birth.
Infections of the reproductive organs can occur from any vaginal delivery, but more commonly occur from birth trauma or from a surgical procedure required to remove the infant from the womb during delivery, called acesareandelivery (C-section).
Types of Postpartum Infections
An infection of the endometrium is calledendometritis. Postpartum people can develop several different infections of the reproductive organs, including some related to surgery. However, the most common is still endometritis.
Postpartum people can also develop:
Infection After C-SectionPostpartum people undergoing cesarean delivery are at higher risk for puerperal fever or postpartum infection.
Infection After C-Section
Postpartum people undergoing cesarean delivery are at higher risk for puerperal fever or postpartum infection.
Puerperal Fever Symptoms
The First 24 HoursOne isolated postpartum fever in the first 24 hours after delivery may not be related to infection. This is because it’s common for people to develop alow-grade feverduring this time and not have an infection. This type of fever resolves on its own.However, persistent fever within 24 hours or two or more fever-range temperatures are generally treated as endometritis/puerperal fever.
The First 24 Hours
One isolated postpartum fever in the first 24 hours after delivery may not be related to infection. This is because it’s common for people to develop alow-grade feverduring this time and not have an infection. This type of fever resolves on its own.However, persistent fever within 24 hours or two or more fever-range temperatures are generally treated as endometritis/puerperal fever.
Endometritis
People with endometritis develop a fever with lower abdominal pain, uterine tenderness, and an elevated heart rate. People will often have vaginal bleeding and a foul odor coming from the vagina.
Wound Infection
Wound infections typically present with redness, warmth, and pain at the incision site.These can occur at the cesarean incision or the episiotomy site. Sometimes there is white or yellow discharge from the incision.
A severe infection can spread deeper into the abdominal cavity. Or, the skin may turn black and blue and peel away.
Urinary Tract Infection
People often complain of pain and burning with urination when they develop a UTI. Other symptoms can include lower abdominal pain and fever.
What Causes Puerperal Fever?
Other risk factors include:
Endometritis is an infection of the uterine lining. The uterine lining, along with thefallopian tubesandovaries, is part of the upper genital tract. During delivery, bacteria usually found in the lower genital tract (thevaginaandcervix) can access the upper genital tract and cause inflammation.
People who have a cesarean delivery are 5 to 10 times more likely to develop endometritis. Other risk factors for this infection include:
Chlamydia InfectionIf a postpartum person develops endometritis more than seven days after delivery, it’s important to consider other causes not related to the delivery, such asChlamydia trachomatis, a sexually-transmitted infection (STI).
Chlamydia Infection
If a postpartum person develops endometritis more than seven days after delivery, it’s important to consider other causes not related to the delivery, such asChlamydia trachomatis, a sexually-transmitted infection (STI).
However, the frequency of postoperative wound infections has significantly declined since the introduction of sterile cleansers used on the skin and antibiotics given before the procedure.
Other risk factors for a wound infection include:
People who have a C-section are at higher risk for developing a UTI, most often due to bladdercatheterizationduring the operation.
Catheterization is a procedure in which a tube is inserted into the urethra to collect urine from the bladder. The most common organism that leads to a bladder infection isEscherichia coli, or E. coli.
Postpartum infections are most often diagnosed based on a healthcare provider’s examination and the patient’s risk factors for specific conditions.
If a person has a persistent fever while taking antibiotics for a postpartum infection or has suspected disease that has spread throughout the body, providers will perform laboratory tests and other imaging studies to look for the source of the infection. They might also perform these tests and studies to ensure something different is not causing the fever
Different types of bacteria cause postpartum infections. Antibiotics treat all of the various conditions. The choice of antibiotic depends on the infection location and the bacteria most likely causing the infection.
Healthcare providers also treat fevers with pain relievers like acetaminophen and ibuprofen. In the hospital, they will often give people intravenous fluids. The postpartum person also needs to rest.
Preventive TreatmentPeople who are undergoing a C-section should be proactively given a dose of antibiotics before the procedure to prevent postoperative wound infections and endometritis.
Preventive Treatment
People who are undergoing a C-section should be proactively given a dose of antibiotics before the procedure to prevent postoperative wound infections and endometritis.
The initial antibiotic choice to treat endometritis isclindamycinplusgentamicin.People with endometritis often require a stay in the hospital to receive intravenous antibiotics.
Wound infections are also treated with antibiotics. The choice of antibiotic depends on the most likely bacteria causing the infection and antibiotic resistance patterns in the community where the person lives.
When the condition is caught early, people can take antibiotics at home and do not need to stay in the hospital.
Healthcare providers are likely to treat a UTI in a postpartum person with antibiotics, even if they look well and have minimal symptoms. This is especially true in patients who underwent bladder catheterization during their C-section.
If endometritis or a significant wound infection is not detected in an appropriate amount of time, the infection can lead to the formation of anabscess, spread throughout the rest of the abdominal area, or spread to blood vessels that carry the infection to the rest of the body.
These infections can be life-threatening, but antibiotics significantly reduce the likelihood of severe infection and death from the disease.
Future InfertilityPeople who develop endometritis are at risk for future infertility.
Future Infertility
People who develop endometritis are at risk for future infertility.
Summary
A Word From Verywell
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hallett C.The attempt to understand puerperal fever in the eighteenth and early nineteenth centuries: the influence of inflammation theory.Med Hist. 2005;49(1):1-28. doi:10.1017/s0025727300000119
Dalton E, Castillo E.Postpartum infections: a review for the non-OBGYN.Obstet Med. 2014;7(3):98-102. doi:10.1177/1753495X14522784
MedlinePlus.Endometritis.
Mackeen A, Packard RE, Ota E, Speer L.Antibiotic regimens for postpartum endometritis.Cochrane Database of Systematic Reviews. 2015;2:CD001067. doi:10.1002/14651858.CD001067.pub3
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
