- 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 may occur any time from rupture of membranes to 42 days after delivery (1).
- Postpartum fever is a sign that requires investigation to determine the specific etiology, which will then dictate treatment.
- Also called postpartum pyrexia or puerperal fever
Etiology and Pathophysiology
- Pathophysiology depends on the cause and site.
- Most commonly from surgical site infections, endometritis, or the breast (1)
- Pelvic and wound infections are caused by polymicrobial vaginal anaerobic and aerobic pathogens (2,3).
- Breast infections arise from skin flora such as Staphylococcus and Streptococcus (4).
- Cesarean deliveries
- Operative vaginal delivery
- Epidural analgesia
- Long operative duration
- Increased duration of active labor
- Membranes ruptured for >6 hours or preterm rupture of membranes
- Multiple pelvic examinations during labor
- Positive GBS status
- Preexisting infection with bacterial vaginosis
- Internal fetal monitoring
- Retained products of conception
- Low socioeconomic status
- Urethral catheterization
- Nipple fissure
- Breast engorgement
- Diabetes mellitus, poorly controlled
- Immunosuppressive therapy
- Immunodeficiency disorder
- Nutritional status
- Appropriate sterile technique during labor and delivery
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Domino, Frank J., et al., editors. "Postpartum Fever." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816959/all/Postpartum_Fever.
Postpartum Fever. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816959/all/Postpartum_Fever. Accessed May 29, 2023.
Postpartum Fever. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816959/all/Postpartum_Fever
Postpartum Fever [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816959/all/Postpartum_Fever.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Postpartum Fever ID - 816959 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816959/all/Postpartum_Fever PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -