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Puerperal fever (from the Latin puer, child), also called childbed fever, can develop into puerperal sepsis, which is a serious form of septicaemia contracted by a woman during or shortly after childbirth, miscarriage or abortion. If untreated, it is life-threatening.
The most common infection causing puerperal fever is genital tract sepsis. Other types of infection that can lead to sepsis after childbirth include urinary tract infection, breast infection (mastitis) and respiratory tract infection (more common after anaesthesia due to lesions in the windpipe).
Puerperal fever is now rare in the West due to improved hygiene during delivery, and deaths have been reduced by antibiotics.
Puerperal fever is no longer favored as a diagnostic category. Instead, contemporary terminology specifies:[1]
The most causative agents in inflammation of the inner lining of the uterus (endometritis) are Staphylococcus aureus and Streptococcus.[2]
Group A Streptococcus (abbreviated to GAS, or more specifically the Streptococcus pyogenes) is a form of Streptococcus bacteria responsible for most cases of severe hemolytic streptococcal illness. Other types (B, C, D, and G) may also cause infection.[3] Group B Streptococcus (abbreviated to GBS, or more specifically Streptococcus agalactiae usually causes less severe maternal disease[4].
Other causal organisms, in order of prevalence, include staphylococci, coliform bacteria, anaerobe bacteria, chlamydia bacteria, mycoplasma and very rarely, Clostridium welchii.
There are several strains of GAS (Group A Streptococcus). Some strains usually cause skin infections, they are more common in warm climates, and they usually cause local rather than systemic effects. Other strains, in particular Streptococcus pyogenes attack the throat and cause severe infections. The human nasopharynx is the main reservoir of Streptococcus pyogenes and infection is more common during winter and it is rarely found in the normal vaginal flora. It is likely that most puerperal hemolytic infections arise from this reservoir in the patient or attendants.[5]
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