Puerperal Fever - Etiology and Risk Factors

Etiology and Risk Factors

Causes (listed in order of decreasing frequency) include endometritis, urinary tract infection, pneumonia\atlectasis, wound infection, and septic pelvic thrombophlebitis. Septic risk factors for each etiologic condition are listed in order of the postpartum day(PPD) on which the condition generally occurs.

  • PPD 0: atelectasis risk factors include general anesthesia, cigarette smoking, and obstructive lung disease.
  • PPD 1-2: urinary tract infections risk factors include multiple catheterization during labor, multiple vaginal examinations during labor, and untreated bacteriuria.
  • PPD 2-3: endometritis ( the most common cause ) risk factors include emergency cesarean section, prolonged membrane rupture, prolonged labor, and multiple vaginal examinations during labor.
  • PPD 4-5: wound infection risk factors include emergency cesarean section, prolonged membrane rupture, prolonged labor, and multiple vaginal examination during labor.
  • PPD 5-6: septic pelvic thrombophlebitis risk factors include emergency cesarean section, prolonged membrane rupture, prolonged labor, and diffuse difficult vaginal delivery.
  • PPD 7-21: mastitis risk factors include nipple trauma from breastfeeding.

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