What is Puerperal Fever?
Postpartum fever, or "postpartum fever", refers to a person who has persistent fever during the postpartum period, or who has a sudden high fever and chills, with other symptoms, similar to a western medicine postpartum infection.
Basic Information
- nickname
- Postpartum fever
- Visiting department
- Gynecology
- Common causes
- Infection with evil poison, exogenous feeling, blood stasis, blood deficiency
- Common symptoms
- Fever, pain, nausea, nausea, vomiting, etc.
Causes of puerperal fever
- Traditional Chinese medicine believes that the etiology and pathogenesis of puerperal fever are infections, venom, blood stasis, and blood deficiency.
- Infection with evil
- The postpartum blood room is opening. If delivery is inadvertent or the care is not clean, the evil poison invades the cell house when it is false.
- 2. Feeling
- Qi and blood suddenly become weak postpartum, the vitality is damaged, the reason is not dense, the external evils enter the imagination, and the camp guards are not in harmony, which can cause fever;
- 3. Blood Stasis
- Postpartum lochia is not smooth, blood stasis stagnates, obstructs air flow, impairs health, and is depressed and feverish;
- 4. Blood deficiency
- Excessive blood loss during delivery and postpartum, sudden deficiency of yin and blood, causing the sun to float out and cause fever.
- Western medicine believes that the main cause of puerperal fever is puerperal infections caused by various bacteria, mycoplasma, and chlamydia. There are mainly two exogenous and endogenous infections. If inadequate disinfection or unclean care during delivery and maternal sexual life before giving birth can cause external pathogens to enter the birth canal and cause infection, it is called exogenous infection. If the maternal body's resistance and immunity declines, the infection caused when the number of pathogens parasitic in the normal pregnant woman's reproductive tract and the increase in virulence is called "endogenous infection".
Clinical manifestations of puerperal fever
- Mainly during the puerperium, fever persists, or there is a sudden high fever, chills, fever, chills, or fever, and other symptoms, such as pain, nausea, nausea, and vomiting.
Thermal examination of puerperium
- Gynecological examination
- Soft birth canal injury, showing local swelling and purulent. Uterine tenderness, thickening of the attachment area, tenderness, or touching inflammatory mass.
- 2. Auxiliary inspection
- (1) Blood counts show increased white blood cell counts and neutrophil counts, and high serum C-reactive protein.
- (2) Pathogenic bacteria can be found in uterine secretions, abscess punctures, posterior fornix puncture bacteria culture or blood culture, anaerobic bacteria culture. Detection of pathogen antigens and specific antibodies can identify pathogens.
- (3) B-ultrasonography showed a dark liquid area in the pelvis, suggesting inflammation and abscesses. CT, magnetic resonance imaging and other detection methods can make localization and qualitative diagnosis of inflammatory masses and abscesses formed by infection.
Puerperal fever diagnosis
- Maternal fever symptoms should be inquired in detail about the medical history and delivery process, carefully inspect the whole body, abdomen, pelvic cavity and perineal wounds, determine the location and severity of infection, and diagnose with combined examination.
Differential diagnosis of puerperal fever
- Steamed milk fever
- 3 to 4 days after delivery, low fever is seen in the lactation period, and it can disappear naturally. It is commonly called "steamed milk" and does not belong to the pathological category.
- 2. Fever of lumps
- Fever of the lumps is manifested as swollen breasts, redness, and heat pain, and even ulcers and pus. Fever accompanied by local breast symptoms is characteristic, while postpartum fever is not accompanied by local breast symptoms.
- Postpartum urination pain, postpartum dysentery, postpartum intestinal diarrhea, and postpartum malaria fever can also occur during the puerperium, but such fever is not closely related to puerperal physiology.
Puerperal fever therapy
- 1. Acute phase anti-infection, antipyretic, nutritional support treatment, correction of water and electrolyte disorders, severe illness or anemia, a small amount of fresh blood or plasma transfusions to enhance systemic resistance.
- 2. When the condition is stable, identify the cause and treat it in a timely manner. For patients with wound abscess infection or pelvic abscess, open incision and drainage in a timely manner. For patients with placental and fetal membranes, clear the uterine cavity after infection control and temperature drop. Severe uterine infection, ineffective treatment, worsening symptoms, uncontrollable bleeding, sepsis, sepsis, etc., hysterectomy should be performed in time. After the condition is stable, the body can be treated with traditional Chinese medicine to enhance immunity.
Postpartum fever prognosis
- The prognosis of puerperal fever varies depending on the cause. If it is a fever caused by blood deficiency, blood stasis, or external sensation, it can be cured quickly and positively and effectively. If it is caused by fever, infection, and mistreatment, it will lead to fever entering the camp blood, reverse pericardial transmission, and even heat to escape, and endanger life.
Puerperal fever prevention
- Strengthen the health care during pregnancy, pay attention to balanced nutrition, and enhance physical fitness. Strengthen health promotion during pregnancy and avoid sex and tub baths two months before delivery. Timely treatment of chronic diseases and complications such as vulvovaginitis and cervicitis. Proper handling of labor, strict aseptic operation during labor, avoid premature rupture of membranes, delayed labor, birth canal injury and postpartum hemorrhage. Taking a semi-recumbent position after delivery is conducive to the discharge of lochia. Prevent the disease before it happens. If there is any possibility of infection such as birth canal pollution, birth canal surgery, premature rupture of membranes, postpartum hemorrhage, etc., antibiotics or traditional Chinese medicine can be given to clear the heat and detoxify the treatment to prevent infection.