A puerperal infection or postpartum infection develops if bacteria infects the uterus and adjacent areas after giving birth. It is projected that 10% of pregnancy-related deaths are due to infections. The death rate is higher in areas with poor sanitation.
This type of infection is uncommon nowadays with the introduction of antiseptics and penicillin. Nevertheless, skin flora such as staphylococcus or streptococcus and other bacterial strains can still trigger infections. These usually thrive in warm and moist environments. A puerperal infection often starts in the uterus after delivery. Take note that the uterus can become diseased once the amniotic sac is infected.
Various types of puerperal infection include:
- Myometritis – uterine muscle
- Endometritis – uterine lining
- Parametritis – areas around the uterus
What are the indications?
- Fever
- Chills
- Lower pelvis or abdominal pain due to the enlarged uterus
- Headache
- Feelings of discomfort or illness
- Foul-smelling vaginal discharge
- Appetite loss
- Pale skin which might be an indication of significant volume blood loss
- Rapid heart rate
These indications might take several days to manifest. Oftentimes, a puerperal infection might not be evident until being released from the hospital. It is vital to watch out for indications of an infection even after discharge from the healthcare facility.
Risk factors
The risk for developing a puerperal infection after delivery varies on the delivery method of the baby.
- 1-3% in normal vaginal deliveries
- 5-15% in scheduled cesarean deliveries done before labor starts
- 15-20% in non-scheduled cesarean deliveries done after labor starts
Additional factors that heightens the risk include the following:
- Obesity
- Anemia
- Young age
- Prolonged labor
- Low socioeconomic group
- Excessive bleeding after delivery
- Bacterial vaginosis
- Having leftover placenta in the uterus after delivery
- Multiple vaginal exams during labor
- Colonization of the vaginal tract by group B streptococcus bacteria
- Internal monitoring of the fetus
- Interruption between rupture of the amniotic sac and deliver
Possible complications
Even though complications are rare, they might develop if the infection is not diagnosed and promptly treated. The possible complications that might arise include:
- Peritonitis or inflammation of the abdominal lining
- Abscesses
- Pulmonary embolism
- Pelvic thrombophlebitis
- Sepsis or septic shock
Management
A puerperal infection is generally treated with oral antibiotics. The doctor might prescribe gentamicin or clindamycin.
The course of antibiotics given is tailored to the strain of bacteria suspected by the doctor responsible for the infection.