What is Puerperium?

Puerperium meaning is the time from the delivery of the placenta appearing in the first week after the delivery. This period usually goes for 6 weeks in duration. Post 6 weeks of the delivery, changes due to pregnancy, labor, and delivery are sorted out. Puerperium is also the postpartum period which is also called the "fourth trimester" is referred to the time the woman goes through after the delivery. This is the time when maternal physiologic changes related to pregnancy return to the previous version. In addition to the physiologic changes and medical attention, health care providers will be aware of the psychological needs. There are certain restrictions the mother goes through in terms of foods and restricting certain activities.


What is Puerperium or the Postpartum Period?

The normal Puerperium definition is quite similar to the above one. There is a common consensus that the postpartum period begins only after the pregnancy period is over. It is often considered six to eight weeks after delivery. However, all systems of the organ do not return to the base in these weeks. According to American College of Obstetricians and Gynecologists, postpartum care extends up to 12 weeks post-delivery.


Puerperal Sepsis

There are different signs of Puerperium, and one such is puerperal sepsis, an infective condition in the mother following childbirth. This is the third most common problem faced by mothers who delivered a kid. According to WHO, there are more than 15% of deaths annually due to this postpartum delivery issue. Many who survive to end up facing long-term health problems like chronic pelvic inflammatory disease (PID) and others. Many doctors use puerperal infection rather than puerperal sepsis. There are three types of postpartum infection a woman can face-

  1. Endometritis: an infection of the uterine lining

  2. Myometritis: an infection of the uterine muscle

  3. Parametritis: an infection of the areas around the uterus


Symptoms of Puerperal Infection:

Different mothers will face different symptoms. This includes-

  • Fever

  • Pain in the lower abdomen

  • Foul smell in vaginal discharge

  • Chills

  • Feeling nausea

How this Infection Takes Place?

Although, due to the introduction of antiseptics the cases of puerperal infection have come down, the skin flora such as Streptococcus or Staphylococcus and other bacteria can end up infecting. The infection usually starts in the uterus after the delivery. It happens when the amniotic sac is infected.


What are the Risk Factors?

The risk of developing an infection is usually different among women. Some may face infection and some may not. The chance of contracting infection is-

  • 3 percent during vaginal delivery

  • 15 percent in scheduled cesarean deliveries

  • 20 percent of non-scheduled cesarean deliveries performed after labor begins

Other than these, there are other factors that can make women face the infection. These are as follows.

  • Obesity

  • Bacterial Vaginosis

  • Multiple Vagincal exams

  • Monitoring of fetus internally

Causes of Puerperal Infection:

As mentioned above, there are different causes of this infection. This infection is bacterial on the genital tract occurring after the birth of the baby. Some of the common bacterial problems you will face are- streptococci, staphylococci, Escherichia coli (E.coli), clostridium tetani, clostridium welchii, chlamydia, and gonococci.


Some of the Infections Postpartum Delivery Can Have are-

  • Nosocomial Infections: These bacteria can come from the hospital environment from the patient's own flora.

  • Endogenous Bacteria: You will find these bacteria traces present in the vagina and rectum which doesn't cause any disease.

  • Exogenous Bacteria: These are the bacteria found in the vaginal area. This can happen outside due to touching by unclean hands, STD, or any unhygienic substance inserted into the vagina.

Diagnosis of Puerperium Infection

There are different diagnoses of this life-threatening infection if there is no clinical inclusion. Some of the diagnosis are as follows.

  • Vomiting

  • Diarrhea

  • Abdominal pain and tenderness

  • Tachycardia

  • Rash

FAQs (Frequently Asked Questions)

1. Is Puerperal Infection Curable?

Ans: One of the reasons why this puerperal infection takes place is because of the unsanitary conditions and unhygienic living. If you have poor quality healthcare systems then you are certainly going to get affected post-delivery. The most vital risk a mother can go through is the type of delivery undergone. It is vital to speak with the doctor regarding the type of delivery you will be undergoing. If you are undergoing cesarean delivery, you need to talk with the doctor about steps to be taken to avoid infection. Some of the steps you can take in case you face puerperal infection:

  • Cleaning out the pubic hair without using the razor

  • Using chlorhexidine-alcohol to prepare the skin

  • Consuming extended-spectrum antibiotics before surgery

2. Does the Puerperal Infection Cause Complications?

Ans: There are rare complications in puerperal infections. However, there are chances of possible infections like-

  • Abscesses or pus

  • Peritonitis or the inflammation

  • Pelvic thrombophlebitis or blood clots in the pelvic veins

Sepsis or septic shock, a condition in which bacteria enters the bloodstream a causing dangerous inflammation.

3. What is the Overall Puerperium Definition?

Ans: Puerperal Sepsis is quite a complex infection that happens post-delivery. It is one of the leading postpartum mortality in the world. Puerperal infections can be a reason because of poor hygiene in the vaginal area. It is vital to have good communication with the doctor to know more about it.

4. How is Puerperal Sepsis Treated?

Ans: In many severe cases, sepsis gets treated with the intervention of the broad-spectrum antibiotics. In case of strong clinical suspicion of sepsis, you should commence parenteral broad-spectrum antibiotics immediately. Doctors, after having a proper inspection of the patient will take undertake fluid resuscitation and oxygen therapy. This is also an important part of the treatment. It is important to note that serum lactate is a measure within 6 hours in case of suspicion of severe sepsis. It is highly recommended to check with the right doctor who will guide you through the medication and ensure the patient doesn’t face many health issues.