Under the postpartum fever (Puerperal fever) one understands inflammation and inflammatory changes in the genital area of the woman during the puerperium, which are triggered by bacteria.
During the birth process there are minor injuries and tears in the mother's birth canal.
Bacteria can then migrate through these small wounds and cause puerperal fever (Puerperal fever) trigger.
As long as the bacteria and the resulting inflammation in the uterus (uterus) remain, the patients usually do not notice any symptoms.
General symptoms only appear when the inflammation spreads. These are fever With chills, a headache and Drowsiness.
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In addition, a increased heartbeat (Tachycardia) and a increased breathing rate (Tachypnea) can be determined.
There is also one Anemia (anemia) with an increase in the number of white blood cells normally present in the blood (Leukocytosis) and a shift in the blood count towards the young blood cells (Left shift) on.
The postpartum fever can be potentially life threatening Blood poisoning (sepsis) or / and one shock to lead.
The symptoms of blood poisoning are fever or hypothermia, increased heart and breathing rates, and changes in the blood count. In some cases it can also lead to a Inflammation of the peritoneum (Peritonitis) come.
The puerperal fever, also called puerperal fever, is an infectious disease and can occur during the puerperium, i.e. six to eight weeks after giving birth occur. Postpartum fever usually occurs during the early morning bed, i.e. in a period from 24 hours to around ten days after delivery. Postpartum fever can also occur after a miscarriage or stillbirth.
$config[ads_text2] not foundThere are many causes of postpartum fever. The most common cause is inflammation of the lining of the uterus, known as puerperal endometritis. It is caused by various pathogens that enter birth injuries, where they can cause inflammation and, if left untreated, lead to blood poisoning (sepsis) to lead.
Another cause of postpartum fever is the incomplete detachment of the afterbirth from the uterus and the occurrence of so-called lochial congestion, i.e. the weekly flow cannot drain properly. In the process, toxins are formed that cause inflammation of the uterus.
Learn more at: Placental detachment after childbirth
A fever can also occur during the milk seeping in or if the breast tissue is inflamed (see below).
Other causes of fever in the puerperium are thromboses or inflammation of the leg veins and infections in the whole body, for example in the gastrointestinal tract, urinary tract or respiratory tract.
There are several factors that increase the risk of developing puerperal fever. These include wound healing disorders that can occur in the event of birth injuries (e.g. a perineal tear) or surgical wounds, e.g. after a caesarean section. Premature rupture of the bladder can also promote the development of puerperium fever.
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During breastfeeding, it can become a particularly early on Milk congestion and inflammation of the breast tissue (Puerperal mastitis) come. This occurs in about one percent of women and is usually caused by germs from the nasopharynx of the baby. During breastfeeding, these spread through small injuries to the nipples and cause inflammation of the breast tissue, especially if the breast is blocked. Are there Pain, swelling, overheating and redness of the affected breast typical. Additionally, the lymph nodes in the armpit may be enlarged and a high fever may occur. The breast infection should treated with antibiotics the woman should continue breastfeeding during this time.
$config[ads_text2] not foundA slight fever can also occur during the milk seepage, which takes place around three to four days after the birth.
After a caesarean section, the risk of developing puerperal fever is due to a Inflammation of the lining of the womb (Puerperal endometritis) elevated. This is particularly the case in the case of an unplanned caesarean section with a previous lengthy birth. The administration of antibiotics can reduce the development of an infection. Wound healing disorders or inflammation of the surgical wound can also cause fever in the puerperium.
The bacteria can through the birth resulting wounds in the uterus and in Vaginal canal penetrate the tissue and trigger an inflammatory reaction there.
If the bacteria penetrate into the vessels and thus into the bloodstream, they can also get one there Blood poisoning trigger.
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There are of course various factors that contribute to the development of postpartum fever (Puerperal fever) favor.
These include the Caesarean section and other surgical interventions that can also be used in natural (vaginal) Childbirth, such as the Perineal cut.
Frequent vaginal exams can also promote postpartum fever.
If the remains of the Mother cake (placenta) remain in the uterus or if it becomes a premature rupture of the bladder, leading to a so-called dry birth can lead, comes or when it leads to one Damming the weekly river (Lochialstau) comes, these are also predisposing for the development of puerperium fever.
The triggering bacteria are mostly bacteria of the groups Streptococci, Staphylococci, Neisseria gonorrhea or Escherichia coli.
However, other bacteria belonging to the group of non-air-dependent bacteria (Anaerobes) cause a puerperium fever.
On the one hand, there is fever in childbed fever longer and higher than with one Uterine lining inflammation (Endometritis), on the other hand the symptoms are like increased pulse (Tachycardia) and the Restlessness showing the way to the patients.
Besides, it smells Weekly flow (Lochien) putrid, which is caused by the decomposition products of the bacteria.
This smell is mostly caused by the sulfur-containing decomposition products which causes bacteria.
The uterus is in pressure painful and little regressed.
A clinical suspicion is sufficient to start therapy, but a vaginal smear be taken.
Since postpartum fever is a bacterial infection, a high dose is used if it is suspected Broad spectrum antibiotic treated until it is clear what exactly the bacterial pathogen is.
Then you can switch to a calculated, tailor-made antibiotic.
Since puerperium fever can be a rare but serious or fatal disease, is a quick start of therapy absolutely necessary.
When the postpartum fever turns into a Blood poisoning (Puerperal sepsis) passes, it can also become a Drop in platelets (Platelets) come what then causal for heavy bleeding and can therefore also be treated, for example, with platelet concentrates.
$config[ads_text1] not foundThe body's own Oxytocin also has a contracting effect (contracting) on the uterus and is mostly used in combination with Methylergotermin given.
Methylergotermin belongs to the ergot alkaloids and has a retroactive effect on the uterus.
A can also be used to remove the inflamed tissue curettage (curettage) the uterus.
If the course is very severe, the Removal of the uterus (hysterectomy) be considered.
It should be noted that this is a difficult procedure because the operation is performed on the inflamed tissue and that it is a definitive, irreversible step.
Of course, this also means that the affected patients can no longer become pregnant.
At a timely start of antibiotic therapy the prognosis is good, as the postpartum fever can heal without any further consequences.
Of course, the prerequisite for this is an early diagnosis and a calculated antibiotic therapy started in good time.
However, if there is one in the further course Blood poisoning, the mortality rate is 20-50%.
This shows once again how essential one is early treatment with a antibiotic is.
The best prophylaxis against postpartum fever is one good and regular disinfection of the hands of medical staff and medical examination equipment.
This is the only way to prevent an infection starting in the hospital (noscomial infection) be prevented.
If the patient has a history of similar diseases, such as one Inflammation of the lining of the womb (Endometritis), can of course also be carried out directly after delivery with a Administration of antibiotics be started for prophylaxis.
The incidence of postpartum fever has been since Disinfection of the hands through the Gynecologist Ignaz Semmelweis fell sharply in the 19th century.
Before Semmelweis tackled the problem, the women very often died of a postpartum fever Blood poisoning (Puerperal sepsis).
Today the incidence in Germany is around 5 percent.
The probability of postpartum fever depends on whether the women give birth at home or in a hospital.
In addition, this probability is also very much determined by the hospital in which the delivery takes place, since each hospital has a different rate for infections that have occurred in the house.
Therefore it makes sense to get a hospital with one if possible low infection and complication rate to look for childbirth.
In general, postpartum fever is now considered to be a rather rare and easily treatable complication of childbirth, both due to the discovery of hand disinfection and antibiotics.
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