II. Definition
- Postpartum uterine infection
III. Causes
-
Group B Streptococcus
- Most common organism in the first 24 hours postpartum
- Mixed anaerobic and aerobic Bacteria
- Most common organisms at 3-7 days postpartum
-
Chlamydia
- Most common organism starting 2-3 weeks postpartum
IV. Signs
- Maternal fever
- Temperature > 38.0 C (100.4 F)
- Two separate recorded values
- Occurs >24 hours Postpartum
- Temperature > 38.7 C (101.5 F)
- Temperature > 38.0 C (100.4 F)
-
General physical examination
- See Differential Diagnosis
- Pelvic examination
- Vaginal hematoma
- Lochia blockage
V. Differential Diagnosis: Seven W's of maternal fever
- Womb
- Wind
- Water
- Walk
-
Wound
- Wound Infection
- Episiotomy infection
- Weaning
- Breast engorgement
- Mastitis
- Breast abscess
- Wonder
- Drug Fever ("wonder drugs")
VII. Radiology
- Chest XRay
- Pelvic Ultrasound when indicated
VIII. Management
- See Endometritis Antibiotic Management
- Continue antibiotics until 1-2 days after afebrile
- Persistent fever >48 to 72 hours despite antibiotics
- Evaluate for pelvic abscess
- Evaluate for septic pelvic Thrombophlebitis
- Consider Drug Fever
