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Postpartum Fever

Elise Bognanno, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Postpartum fever or puerperal fever is defined as an oral temperature of 38°C (100.4°F) on two separate occasions at least 4 hours apart or of >38.5°C (101.6°F) at any time. This ...

DIAGNOSIS

HISTORY

  • Mode of delivery

  • Prophylactic medication given prior to surgery

  • Premature rupture of membranes

  • Rupture of membranes >6 hours

  • GBS status

  • Pelvic pain or foul smelling lochia

  • Surgical incis...

TREATMENT

GENERAL MEASURES

  • Fluid management

  • Oxygen therapy if necessary

  • Assess for signs of septic shock or septicemia.

  • Treatment by condition:

    • Endometritis

      • Parenteral broad-spectrum antibiotics: IV tre...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

All patients with a postpartum fever should be seen in follow-up with an OB/GYN or family physician who practices obstetrics. 

PATIENT EDUCATION

  • Explain rationale f...

REFERENCES

1
Dalton E, Castillo E. Post partum infections: a review for the non-OBGYN. Obstet Med.  2014;7(3):98–102. [View Abstract on OvidMedline]
2
Jaiyeoba O. Postoperative infections in obstetr...

ADDITIONAL READING

World Health Organization. Mastitis: Cause and Management. Geneva, Switzerland: World Health Organization; 2000 [View Abstract on OvidMedline]

CODES

ICD10

  • O86.4 Pyrexia of unknown origin following delivery

  • O86.19 Other infection of genital tract following delivery

  • O91.12 Abscess of breast associated with the puerperium

  • O86.0 Infection of obstetr...

CLINICAL PEARLS

  • With endometritis—if no resolution of fever after 48 hours of broad-spectrum IV antibiotic, must get a CT scan of abdomen/pelvis to look for other causes (abscess, hematoma, SVT)

  • All ma...

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