II. Definition

  1. Postpartum uterine infection

III. Causes

  1. Group B Streptococcus
    1. Most common organism in the first 24 hours postpartum
  2. Mixed anaerobic and aerobic Bacteria
    1. Most common organisms at 3-7 days postpartum
  3. Chlamydia
    1. Most common organism starting 2-3 weeks postpartum

IV. Signs

  1. Maternal fever
    1. Temperature > 38.0 C (100.4 F)
      1. Two separate recorded values
      2. Occurs >24 hours Postpartum
    2. Temperature > 38.7 C (101.5 F)
  2. General physical examination
    1. See Differential Diagnosis
  3. Pelvic examination
    1. Vaginal hematoma
    2. Lochia blockage

V. Differential Diagnosis: Seven W's of maternal fever

VII. Radiology

  1. Chest XRay
  2. Pelvic Ultrasound when indicated

VIII. Management

  1. See Endometritis Antibiotic Management
    1. Continue antibiotics until 1-2 days after afebrile
  2. Persistent fever >48 to 72 hours despite antibiotics
    1. Evaluate for pelvic abscess
    2. Evaluate for septic pelvic Thrombophlebitis
    3. Consider Drug Fever

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window