Postpartum Pyrexia

Question 1

What is postpartum pyrexia defined as ?

Answer 1

Defined as fever >38 in the first 14 days postpartum

Question 2

It is usually caused by genital tract sepsis, what are the 3 pathogens involved ?

Answer 2

Group A Streptococcus, staphylococcus aureus and E. coli

Question 3

What is they mnemonic for the causes of Postpartum pyrexia ?

Answer 3

B-5W

Question 4

What are the causes of postpartum pyrexia ?

Answer 4

Breast: mastitis and engorgement 
Womb: endometritis and sepsis 
Wound: v-section and IV access sites 
Water: UTI and bowels 
Walking: DVT(Low grade pyrexia) and thrombophlebitis 
Wind: Atelectasis and pneumonia

Question 5

What are 2 risk factors for endometritis?

Answer 5

1. Retained products and 2. Prolonged rupture of membranes

Question 6

What are the 3 clinical features of endometritis?

Answer 6

1. Fever, 2. Offensive vaginal lochia 3. Abdominal pain and uterine tenderness or enlargement

Question 7

What does the initial management of postpartum pyrexia involve (2) ? 😭

Answer 7

Examination (5): examination of the abdomen, breast, chest, IV access sites and legs l; Ix: bloods + culture (uterus, high vaginal and Fetus)

Question 8

What is the mnemonic for the management of postpartum pyrexia ?

Answer 8

IV AFO

Question 9

What is the management of Postpartum pyrexia ?

Answer 9

Admit for IV AFO: antibiotics, fluids and oxygen until afebrile for 24 hours

Question 10

What is clostrium ?

Answer 10

A yellow fluid secreted in the first 3 days postpartum before milk production, which is normal