Postpartum Fever

Aka: Postpartum Fever, Maternal Fever, Puerperal Infection, Peripartum Infection, Maternal Pyrexia, Intrapartum Fever

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II. Epidemiology

  1. Incidence Peripartum Infection: 5-7% (higher following Cesarean Section)

III. Causes

  1. Female genital tract is most common source (esp. Surgical Site Infections)
  2. See Differential Diagnosis

IV. Risk Factors: Postpartum Infection (esp. Surgical Site Infection)

  1. Cesarean Section
  2. Diabetes Mellitus
  3. Obesity
  4. Systemic Corticosteroids (prolonged use)
  5. Tobacco Abuse
  6. Chorioamnionitis (or other concurrent infection)
  7. Bacterial Vaginosis

V. Diagnosis

  1. Postpartum Fever is Temperature >38.5 in the first 24 hours after delivery

VI. Differential Diagnosis: Seven W's of Maternal Fever

  1. Womb
    1. Postpartum Endometritis (or Chorioamnionitis)
  2. Wind
    1. Atelectasis is not cause of fever (fever and atelectesis are caused by major surgery)
    2. Pneumonia
  3. Water
    1. Urinary Tract Infection
  4. Walk
    1. Deep Vein Thrombosis
    2. Pulmonary Embolism
    3. Pelvic Vein Thrombophlebitis
  5. Wound
    1. Cesarean Section related infection
    2. Episiotomy infection
    3. Epidural Abscess
  6. Weaning
    1. Breast engorgement
    2. Postpartum Mastitis
    3. Breast Abscess
  7. Wonder
    1. Drug Fever ("wonder drugs")

VII. References

  1. Dalton (2014) Obstet Med 7(3): 98–102 +PMID:27512432 [PubMed]
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934978/

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