Excerpt from Pregnancy, Postpartum Infections

Synonyms, Key Words, and Related Terms: endometritis, puerperal infection, postsurgical wound infections, perineal cellulitis, mastitis, respiratory complications from anesthesia, retained products of conception, urinary tract infections, UTI, septic pelvic phlebitis, mastitis, pyelonephritis, genital tract infections, thrombosis, perineal cellulitis, episiotomy, Bacteroides, Clostridium, Escherichia coli, E coli, Staphylococcus aureus, S aureus, Klebsiella, Proteus, Enterobacter

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Background: Emergency physicians are increasingly concerned about postpartum patients who come to the ED with a fever or evidence of infection. The number of cases of infection can be expected to increase because of the earlier discharge of postpartum patients from the hospital. Any infection following delivery is classified as postpartum or puerperal infection.

Pathophysiology: Endometritis is the most common source of postpartum infection. Other sources of postpartum infections include (1) postsurgical wound infections, (2) perineal cellulitis, (3) mastitis, (4) respiratory complications from anesthesia, (5) retained products of conception, (6) urinary tract infections (UTIs), and (7) septic pelvic phlebitis.

Frequency:

In the US: Overall, postpartum infection is estimated to occur in 1-8% of all deliveries.

Mortality/Morbidity: In most reviews, maternal death rates associated with infection range from 4-8%, or approximately 0.6 maternal deaths per 100,000 live births.