Postpartum fever

O85/O86.0-4/O86.8


DESCRIPTION

During delivery the woman's protective barrier against infections is temporarily reduced and this may lead to infections.
The cause of fever may be a serious complication.
Consider excessive use of misoprostol for PPH (doses >600 mcg) as a possible non-infectious cause of postpartum fever.

GENERAL MEASURES

Prevent deep vein thrombosis.
Complete evacuation of uterine contents.
Hysterectomy may be indicated in severe uterine sepsis.
Attention to breast engorgement.

MEDICINE TREATMENT

Antibiotic treatment, where appropriate, should be guided by the presumed source of infection.

Empiric antibiotic therapy

  • Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly, until patient apyrexial for 24 hours.

LoEIII

Follow with:

  • Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.

REFERRAL

  • No clinical response in 48 hours of antibiotic treatment.
  • Septic shock.