Childbed fever - symptoms, treatment & tips from midwife Katharina
Puerperal fever can be treated very well today. You can read everything you need to know about puerperal fever here.
Even today, puerperal fever is a dreaded complication of the postpartum period. However, while it was very common until the 19th century and cost many women their lives, it is now rare and can now be easily treated. The cause of puerperal fever is an inflammation of the genital organs caused by the birth or injuries sustained during labour.
This is triggered Puerperal fever caused by bacteria. Since the link between poor hygiene at birth and the development of puerperal fever has been recognised, this disease has become less common. Because antibiotics are now available for treatment, puerperal fever has lost its terror.
Puerperal fever must be differentiated from other diseases. After all, a woman who has recently given birth can also get any other infectious disease. Only if the illness is related to the birth or the birth injuries is it referred to as puerperal fever.
Childbed fever: You need to look out for these symptoms
The trigger for fever in the postpartum period is a bacterial infection that migrates from the labour wounds into the uterine lining. If it remains untreated, it moves further into the muscle of the uterus. This is known as endomyometritis. From there, the path to all other organs of the body is not far away. The uterine muscle is well supplied with blood. Germs are therefore flushed from there particularly quickly with the blood.
It takes time from inflammation of the birth wounds to puerperal fever. If these inflamed wounds are treated, the development of puerperal fever can be prevented.
Only when the bacteria spread do the first symptoms of illness appear. At first it feels like you have the flu. Typical symptoms of puerperal fever are
- persistent fever above 38° Celsius
- Headache
- Chills
- Drowsiness
Many mothers also have a Tachycardia (increased heart rate) and a Tachypnoea (increased respiratory rate) is observed.
A foul-smelling postpartum discharge and a build-up of milk can also be a sign of the onset of postpartum fever. Ask your midwife about this.
When do I need to see a doctor about puerperal fever?
Puerperal fever also triggers anaemia (anaemia) and an increase in leukocytes (leukocytosis). This results in a left shift in the blood count. If puerperal fever is not recognised and remains untreated, it can lead to life-threatening shock and blood poisoning.
You can recognise blood poisoning by fever and/or hypothermia. There is also an increased respiratory and heart rate. If you notice these symptoms after giving birth in the puerperium, you should visit your maternity clinic. In rare cases, this can also lead to Peritonitis (peritonitis) can occur.
You should always go to the doctor immediately if you have a fever and flu-like symptoms. After a thorough examination and a diagnosis of "postpartum fever", the doctor will prescribe an antibiotic.
When does puerperal fever occur?
The symptoms of postpartum fever often appear as early as 24 hours to ten days after the birth. The risk is generally greatest in the first six to eight weeks after the birth.
During labour, the cervix dilates, making it very easy for bacteria to ascend towards the uterus. But how do the bacteria get into the uterus in the first place? The afterbirth leaves a so-called uterine wound when it detaches. It is very easy for bacteria to enter the body via this wound. Other birth injuries such as tears in the genitals increase the risk of infection for puerperal fever.
Other triggers for fever in the postpartum period
Fever in the puerperium can also have other causes, as it is not only bacteria that enter the uterus from labour wounds that can trigger puerperal fever. If the afterbirth does not detach completely, puerperal fever can also occur. In this case, the body's own wound closure cannot function properly. The regression of the uterus is disturbed by the placenta remnant. Your body's defence against germs then does not work properly. A lochial blockage (postpartum haemorrhage) can also be a trigger for postpartum fever. If you have a lochial blockage, your menstrual flow cannot drain properly. Germs are then not flushed out of the uterus, but can multiply well in the blocked lochia. The lochial congestion is then the trigger for postpartum fever.
An additional risk is posed by an episiotomy or perineal tear. Both also increase the risk of infection. This is because these wounds are very close to the anus and therefore intestinal bacteria can penetrate more easily.
Premature rupture of the membranes during childbirth without the onset of labour, frequent vaginal examinations during childbirth, a long duration of birth and a caesarean section increase the risk of puerperal fever. It is therefore standard medical practice to give an antibiotic prophylactically in these cases. Germs should be treated before they trigger this dreaded postpartum complication.
Other risk factors for puerperal fever
If you suffer from a wound healing disorder, the risk of fever in the postpartum period could be significantly increased for you. The body, especially the body of the woman who has recently given birth, actually has a defence against invading germs with its wound healing and immune system. If the body's defences are weakened, germs can multiply more easily in the body.
Treatment & therapy of puerperal fever
If you notice symptoms of postpartum fever, you should go to the doctor or your maternity clinic immediately. They will take a blood sample and analyse it. If he finds inflammation levels, he will choose a suitable treatment. In most cases, puerperal fever is treated with a very high-dose broad-spectrum antibiotic, as this is a bacterial infection.
At the same time, the cause of the infection is also sought and treated. If there is a lochial blockage, this must be rectified. If birth wounds are the source of the infection, these are treated.
As soon as the doctor knows what type of bacterial infection it is, they will choose a suitable antibiotic. These usually work very well and you will notice an improvement after just a few days. Only very rarely does it happen that the puerperal fever is very severe and you need longer treatment.
How long does puerperal fever last?
The faster the treatment is started, the better the chances of a short course of puerperal fever. It is therefore very important to start treatment with antibiotics in good time. Early treatment is also important because the risk of septicaemia is extremely high and can be life-threatening.
How can I prevent fever in the postpartum period?
The best prophylaxis is proper hygiene and protection. And this starts in hospital. Washing your hands is particularly important. Taking care of the perineal suture and changing your pads frequently prevents germs from multiplying unhindered. Never use tampons; thick pads that absorb the flow are better. Shower regularly and clean your genital area with lukewarm water.
If you take it easy in the postpartum period, your immune system will have enough strength to heal wounds and eliminate germs before they can make you ill. The postpartum period is not only the time you should take to get to know your child, but also to heal the wounds and stress of the birth in peace. This is the best prophylaxis for all postpartum disorders. This is the best prophylaxis for puerperal fever.
How dangerous is puerperal fever?
The mortality rate for puerperal fever in Germany is less than five per cent. The faster you are treated with antibiotics, the faster you will recover. It is therefore very important that you go to the doctor or hospital immediately if you suspect you have puerperal fever and have yourself thoroughly examined. Generally speaking, however, puerperal fever can be treated very well nowadays and in the vast majority of cases there is a positive recovery.
These are other triggers of fever and inflammation in the postpartum period
A milk blockage can develop into a Mastitis, inflammation of the mammary glands develop. This is also accompanied by high fever and symptoms similar to puerperal fever. Ultimately, both can lead to blood poisoning. You can recognise the difference by the different areas of the body. With mastitis, your breast hurts. With puerperal fever, you will notice the pain in the labour wounds and the uterus.
Thrombosis can also lead to fever in the postpartum period. Other reasons for fever in the postpartum period can be
- inflamed leg veins
- Bladder infections
- Gastrointestinal problems
- Other infections in the body
A precise diagnosis is therefore necessary for treatment. It is not enough just to treat the germs. The cause of the fever must also always be found and treated.
Catherine
