POSTPARTUM PYREXIA Definition any fever of > 38.0 ?C on any 2 of the first 10 days postpartum, except the first day Causes W i...
POSTPARTUM PYREXIA
Definition
any fever of > 38.0 ?C on any 2 of the first 10 days postpartum, except the first day
Causes
- Wind
- atelectasis (especially after general anesthesia)
- pneumonia
- Water (UTI)
- Wound (gram +/- aerobes, and anaerobes)
- C-section incision site
- episiotomy site
- empiric treatment: clindamycin + gentamicin
- prophylaxis against post-C/S endometritis
- begin antibiotic immediately after cord clamping and administer only 1-3 doses
- cefazolin is most common
- Walking
- pelvic thrombophlebitis (diagnosis of exclusion)
- DVT
- Breast
- engorgement may cause slight physiologic temperature rise on first day
- mastitis (Staphylococcus aureusmost common)
- Endometritis : blood and genital cultures
POSTPARTUM MOOD ALTERATIONS
Postpartum blues
- very common, 85% of new mothers
- onset day 3-10
- considered an extension of the “normal” hormonal changes and adjustment to a new baby
- self-limited, does not last more than 2 weeks
- signs and symptoms of major depression occurring in a woman within 6 months of childbirth
- incidence of 10-20%suspect if the ìbluesî last beyond 2 weeks, or if the symptoms inthe first two weeks are severe (e.g. extreme disinterest in the baby, suicidal or homicidal ideation)
- treatment with antidepressants is often necessary
- interferes with bonding and attachment between mother and baby so it can have long term effects
- rare (0.2%)
- presents as an acute psychotic episode, or can occur in the context of a depression
