Puerperal_Pyrexia_Flashcards

Question 1

What is the definition of Puerperal pyrexia?

Answer 1

Puerperal pyrexia may be defined as a temperature of > 38ºC in the first 14 days following delivery.

Question 2

What is the most common cause of Puerperal pyrexia?

Answer 2

Endometritis is the most common cause of Puerperal pyrexia.

Question 3

What are some causes of Puerperal pyrexia?

Answer 3

Causes of Puerperal pyrexia include endometritis, urinary tract infection, wound infections (perineal tears + caesarean section), mastitis, and venous thromboembolism.

Question 4

What is the management if endometritis is suspected in Puerperal pyrexia?

Answer 4

If endometritis is suspected, the patient should be referred to hospital for intravenous antibiotics (clindamycin and gentamicin until afebrile for greater than 24 hours).

Question 5

summarise Puerperal pyrexia

Answer 5

Puerperal pyrexia

Puerperal pyrexia may be defined as a temperature of > 38ºC in the first 14 days following delivery.

Causes:
endometritis: most common cause
urinary tract infection
wound infections (perineal tears + caesarean section)
mastitis
venous thromboembolism

Management
if endometritis is suspected the patient should be referred to hospital for intravenous antibiotics (clindamycin and gentamicin until afebrile for greater than 24 hours)

Question 6

A 24-year-old woman presents to her GP 8 days after giving birth. She complains of a persistent pink vaginal discharge which is ‘smelly’. On examination her pulse is 90 / min, temperature 38.2ºC and she has diffuse suprapubic tenderness. On vaginal examination the uterus feels generally tender. Examination of her breasts is unremarkable. Urine dipstick shows blood ++. What is the most appropriate management?

• Arrange urgent ultrasound to exclude retained products + send MSSU + take high vaginal swab
• Send MSSU + take high vaginal swab + start oral co-amoxiclav + metronidazole
• Take high vaginal swab + paracetamol 1g qds with review tomorrow
• Admit to hospital
• Send MSSU + take high vaginal swab + start oral co-amoxiclav

Answer 6

Admit to hospital
This woman by definition has puerperal pyrexia, likely secondary to endometritis. She needs to be admitted for intravenous antibiotics.