Postpartum pyrexia

Anbazhagan, A; Harper, Ann

doi:10.1016/j.ogrm.2015.06.004

Cited by 7 publications

(21 citation statements)

References 4 publications

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“…However, our findings contrary to other studies [3,12], found no association between PP and prolonged rupture of membranes (PROM). This is probably due to routine use of broad spectrum antibiotics in patients with PROM at the DGH, as prophylaxis for chorioamnionitis and subsequent neonatal sepsis.…”

Section: Discussioncontrasting

confidence: 99%

“…Contrary to previous reviews [3,10] which reported puerperal sepsis as the leading cause of postpartum pyrexia, malaria was the single most frequent cause of postpartum pyrexia observed in this study. The high incidence of postpartum malaria observed is typical to that described in a Gabonese study [20], which revealed that puerperal women were susceptible to a considerable risk of developing malaria.…”

Section: Discussioncontrasting

confidence: 99%

“…Six different species of bacteria were observed from high vaginal swabs cultures reviewed, with E. coli and group-A beta hemolytic streptococci being the most frequent. This result is highly reflective of the polymicrobial nature of puerperal sepsis, as reported in literature [3,10,21,23]. The importance of timing the onset of pyrexia postpartum, cannot be over emphasized.…”

Section: Discussionmentioning

confidence: 63%

“…Postpartum pyrexia is relatively common, occurring in approximately 5-7% of births [3], with global rates decreasing as progress is being made towards Sustainable Development Goal-3 [4]. However, postpartum pyrexia remains a leading contributor to maternal morbidity and mortality, especially in Sub-Saharan Africa, where 99% of maternal deaths occur [1].…”

Section: Introductionmentioning

confidence: 99%

“…Other significant causes of postpartum pyrexia include urinary tract infections, surgical wound infection, malaria, septic thrombophlebitis and mastitis [8]. In addition to trauma sustained during the birth process or caesarean procedure, physiologic changes during pregnancy contribute to the development of postpartum infections [3]. Other factors that increase susceptibility to sepsis and subsequent pyrexia in the postpartum period include anaemia, prolonged labour, frequent vaginal examinations in labour under unsterilized circumstances, and prolonged premature rupture of membranes [3,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

Ngunyi

Halle-Ekane

Tendongfor

et al. 2020

Preprint

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Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP. Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

Ngunyi

Halle-Ekane

Tendongfor

et al. 2020

Preprint

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Top 10 Pearls for the Recognition, Evaluation, and Management of Maternal Sepsis

Shields

Assis

Halscott

2021

Obstetrics &Amp; Gynecology

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General practitioners’ management of mastitis in breastfeeding women: a mixed method study in Australia

Amir,

Crawford,

Cullinane

et al. 2024

BMC Prim. Care

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Background Mastitis is a common reason new mothers visit their general practitioner (GP). In Australia, the Therapeutic Guidelines: Antibiotic provides practical advice to GPs managing a range of infections, including mastitis. It is not known if Australian GPs prescribe antibiotics and order investigations as recommended for the management of mastitis. Methods A convergent mixed methods design integrated quantitative analysis of a general practice dataset with analysis of interviews with GPs. Using the large-scale primary care dataset, MedicineInsight, (2021–2022), antibiotics prescribed and investigations ordered for mastitis encounters were extracted. Mastitis encounters were identified by searching ‘Encounter reason’, ‘Test reason’ and ‘Prescription reason’ free text field for the term ‘mastitis’; ‘granulomatous mastitis’ was excluded. Clinical encounters for mastitis occurring within 14 days of a previous mastitis encounter were defined as belonging to the same treatment episode. Semi-structured interviews were conducted with 14 Australian GPs using Zoom or telephone in 2021–2022, and analysed thematically. The Pillar Integration Process was used to develop a joint display table; qualitative codes and themes were matched with the quantitative items to illustrate similarities/contrasts in findings. Results During an encounter for mastitis, 3122 (91.7%) women received a prescription for an oral antibiotic; most commonly di/flucloxacillin ([59.4%]) or cefalexin (937 [27.5%]). Investigations recorded ultrasound in 303 (8.9%), blood tests (full blood examination [FBE]: 170 [5.0%]; C-reactive protein [CRP]: 71 [2.1%]; erythrocyte sedimentation rate [ESR]: 34 [1.0%]) and breast milk or nipple swab cultures in approximately 1% of encounters. Analysis using pillar integration showed consistency between quantitative and qualitative data regarding mastitis management. The following themes were identified: - GPs support continued breastfeeding. - Antibiotics are central to GPs' management. - Antibiotics are mostly prescribed according to Therapeutic Guidelines. - Analgesia is a gap in the Therapeutic Guidelines. - Low use of breast milk culture. Conclusions Prescribing antibiotics for mastitis remains central to Australian GPs’ management of mastitis. Interview data clarified that GPs were aware that antibiotics might not be needed in all cases of mastitis and that delayed prescribing was not uncommon. Overall, GPs followed principles of antibiotic stewardship, however there is a need to train GPs about when to consider ordering investigations.

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Postpartum pyrexia

Cited by 7 publications

References 4 publications

Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

Top 10 Pearls for the Recognition, Evaluation, and Management of Maternal Sepsis

General practitioners’ management of mastitis in breastfeeding women: a mixed method study in Australia

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