Curriculum · Gynecology / Women's Health / Infertility / Perinatal Care / Birth Spacing
Postpartum endometritis
What it is
Postpartum endometritis is one of the pregnancy related causes of postpartum pyrexia, also called puerperal pyrexia, which is defined as a T of 38 on any 2 of the 1st 10 postpartum days, excluding the 1st 24 hours; a low grade fever in the 1st 24 hrs is normal. It is the most common cause of postpartum fever, especially after cesarean. It is also a cause of late postpartum bleeding: postpartum bleeding is classified as early, within 24 to 48 hours of delivery, or late, up to 1 to 2 weeks, and the late episodes may be caused by endometritis or by retained products of conception.
Causes and risk
The risk factors are cesarean section, prolonged labour, prolonged rupture of membrane, vaginal examination, retained products after conception, bacterial vaginosis and GBS, and it is more common after CS. The pathogens named are group B Streptococcus and Gardnerella vaginalis. Another page sets the risk factors out by group for postpartum pyrexia as a whole: the obstetric ones are prolonged labor, prolonged rupture of membranes, multiple vaginal exams and operative delivery by forceps, vacuum or cesarean; the maternal ones are diabetes, anemia, obesity and immunosuppression; and the environmental ones are poor asepsis during delivery and retained placental tissue.