What are the symptoms of puerperal fever

Puerperal fever, also known as puerperal infection, refers to a symptom of infection caused by the invasion of pathogens into the reproductive tract during the postpartum period. There are local infections and systemic infections may also occur. Puerperal disease generally refers to the period from childbirth to ten days. This time often induces urinary tract infection, mastitis, respiratory diseases, etc., and is prone to cause pelvic connective tissue inflammation and acute salpingitis.

What are the symptoms of puerperal fever

1. Acute vulvar, vaginal, and cervicitis

Infection caused by perineal injury or surgical delivery during delivery is manifested by local burning, pain, and dripping purulent secretions that irritate the urethra and cause urinary pain and frequent urination. The infected sutures in the wound were stuck in the swollen tissue, and pus was oozing from the needle holes. Vaginal and cervical infections are manifested by mucosal congestion and ulcers and increased purulent secretions. The symptoms caused by cervical laceration are mostly not obvious. If the depth reaches the dome and broad ligament and is not sutured in time, the pathogens can directly ascend or spread to the lymphatic tissue and cause pelvic connective tissue inflammation.

2. Uterine infection

Postpartum uterine infections include acute endometritis and myometritis. When bacteria invade through the placental detachment surface and spread to the decidua, it is called endometritis. When the infection invades the myometrium, it is called myometritis. Endometritis with myometritis. In severe cases, patients may experience chills, high fever, headache, rapid heart rate, leukocytosis, lower abdominal tenderness of varying severity, and lochia may not be excessive, making it easy to be misdiagnosed.

3. Acute pelvic connective tissue inflammation, acute salpingitis

The pathogens travel along the parauterine lymph or blood to the parauterine tissues, causing an acute inflammatory reaction to form an inflammatory mass that also affects the fallopian tube mesentery and the wall of the tube. If the entire pelvic cavity is invaded, a "frozen pelvis" may also form. Gonorrhea bacteria ascend along the genital tract mucosa to infect the fallopian tubes and pelvic and abdominal cavities, forming abscesses, which may cause persistent high fever.

4. Acute pelvic peritonitis and diffuse peritonitis

The inflammation continues to develop and spreads to the uterine serosa, forming pelvic peritonitis and then developing into diffuse peritonitis, with symptoms of systemic poisoning, such as high fever, nausea, vomiting, abdominal distension, and obvious tenderness and rebound pain in the lower abdomen during examination. Because the abdominal wall of the parturient is relaxed, the tension of the abdominal muscles is often not obvious. Intestinal adhesions caused by inflammatory exudation of the peritoneal surface and cellulose covering may also form localized abscesses in the rectouterine pouch. If the abscess spreads to the intestine and bladder, diarrhea, tenesmus and dysuria may occur. If the acute phase is not treated thoroughly, it may develop into chronic pelvic inflammatory disease and lead to infertility, affecting the fertility of a second child.

5. Thrombophlebitis

Bacteroides and anaerobic streptococci are common pathogens. On the basis of blood stasis or damage to the venous wall, bacteria secrete heparinase to break down heparin and promote coagulation. When the placental attachment surface of the uterine wall is infected with the above bacteria, it causes pelvic thrombophlebitis. The ovarian vein, uterine vein, internal iliac vein, common iliac vein and inferior vena cava may be affected. The lesions are often unilateral. Most patients present 1-2 weeks after delivery with chills and high fever, which recur after endometritis and last for several weeks, making it difficult to distinguish from pelvic connective tissue inflammation. In lower extremity thrombophlebitis, the lesions are mostly in the femoral vein, popliteal vein and great saphenous vein, and remittent fever occurs. Persistent pain in the lower limbs, local venous tenderness or the touch of hard cords, obstruction of blood return, causing edema of the lower limbs and pale skin, commonly known as "white swelling of the thighs". However, some lesions are mild or deep without obvious positive signs and can be detected by color Doppler ultrasound. Thrombophlebitis of the lower extremities is often secondary to pelvic phlebitis or surrounding connective tissue inflammation.

6. Sepsis and septicemia

When infected blood clots break off and enter the blood circulation, they can cause sepsis, lung, brain, kidney abscesses, or pulmonary embolism, leading to death. If a large number of bacteria enter the blood circulation and multiply to form sepsis, it can be life-threatening.