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Maternal (puerperal) sepsis

Sepsis puerperalis · Mateřská (puerperální) sepse

female only

What it is

Infection in pregnancy or the six weeks after birth, most often of the womb, that leads to organ failure; about 1 in 10 maternal deaths worldwide.

Symptoms & signs

  • Fever or low temperature, shivering
  • foul-smelling discharge
  • tender womb, lower abdominal pain
  • fast pulse and breathing
  • confusion, low blood pressure
  • pain out of proportion — group A streptococcus

🚩 Get help if…

  • call 112 / 911 now Fever or shivering with a racing heart or fast breathing
  • call 112 / 911 now Confused, very drowsy, or mottled or cold skin
  • call 112 / 911 now Severe belly pain or foul-smelling discharge after birth
  • see a doctor soon Wound red, hot, leaking, or painful breasts with fever

Where it strikes

Medical treatment

  • IV broad-spectrum antibiotics within the hour, covering group A streptococcus
  • cultures, lactate, fluids, urine output
  • removal of retained placenta, drainage of abscess; hysterectomy for necrotising infection
  • Antibiotic before caesarean — about 60% fewer wound and womb infections trials support
  • One antibiotic dose after forceps or vacuum birth — ANODE trial: infections cut from 19% to 11% trials support
  • Azithromycin in labour in low- and middle-income countries — A-PLUS trial: sepsis or death 1.6% vs 2.4% trials support

Natural & lifestyle

  • Clean hands, clean birth — Semmelweis's handwashing is still the core
  • see a doctor the same day for fever after birth
  • treat anaemia

Emerging & experimental

  • Obstetric early-warning scores
  • biomarkers for earlier detection
  • group A streptococcus vaccine research

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Postpartum herbal steam baths — traditional; do not treat infection anecdotal / traditional
  • Waiting on home remedies for fever after birth — delays antibiotics; can be fatal anecdotal / traditional

ICD codes