Postpartum Infection

Postpartum infection refers to an infection in new mother within 4-6 weeks after childbirth that is strongly associated with the delivery process. Although, due to improvement in the sanitation and clinical practices, the incidence of postpartum infection is minimal but it should be known that the chances are substantial mainly because there are many open and healing wounds in your body (both exterior and interior) that may get infected if contamination is introduced in the open wounds; for example uterus at the site of placental detachment can get infected.

It is important to keep in mind that sometimes other parts of the body may get infected after childbirth besides reproductive system; like urinary bladder, kidney or ureter, especially in women who are catheterized during childbirth. Postpartum infection is reported in as many as 8% of all deliveries.

Symptoms of Postpartum Infection

Signs and symptoms of postpartum infection may be non-specific like high grade fever, malaise, weakness, agitation, headaches but may be specific like:

• Signs of urinary tract infection that is fairly common in most perineal or pelvic infections (especially in postpartum women). The symptoms include cloudiness of urine, difficulty in passing urine due to severe burning sensation and pelvic pain, increase in the urgency and frequency if urine (with passage of very small quantities of urine).
• Increase in the swelling, pain, warmth, redness or irritation of the skin around the tear, abrasion, incision, suture or surgical site.
• Pain in one or both breast compounded by swelling, edema, prominence of veins, redness, rise in the temperature of local skin or similar lesions (suggestive of breast-duct infection also known as mastitis and very common in nursing mothers).
• Discharge of blood, pus (or a mix of both) with lochia. The discharge may be foul-smelling and can cause irritation or itching of surrounding skin.

Different Types of Postpartum Infection

It is very important to identify the type and source of infection as early as possible in order to prevent life threatening complications. Infections that involve uterine cavity can increase the risk of Endometritis that may complicate future pregnancies and if infectious agents gain access to blood stream, the risk of sepsis increases many folds. Infection in urinary system can increase the risk of renal stone formation, cause severe discomfort and delays your healing or recovery. The common types and causes of postpartum infection are：

1. Uterine Infections

Uterine infections usually follow after abortion; however, in situations of poorly managed labor (torn placenta or incomplete evacuation of placenta). Some tissue segments remain that may lead to uterine infection. Most commonly reported symptoms are foul smelling discharge, high grade fever, racing heart rate, abdominal pain, swelling of lower abdomen and indigestion.

Endometritis (or infection of uterine lining) is fairly common in following circumstances:

• A history of prolonged labor
• Use of unsanitary instruments in the process of delivery (in home delivery or delivery in untrained hands)
• History of prolonged rupture of membranes
• Assisted or instrumental vaginal delivery

Speaking to a healthcare provider should be the first course of action. Intravenous antibiotics are needed to resolve the infection with or without the evacuation of retained placental products.

2. Mastitis

Mastitis is another common postpartum infection that is fairly common in mothers who gave birth for the first time; however, this is not a universal rule. The cause of mastitis is clogged up ducts that block the milk flow and initiate inflammatory process. The risk factors include:

• An inability to feed the baby poorly (due to poor latch)
• Cracked nipples that introduce the germs in the skin

Massaging the breast or use of warm compresses help in reducing the pain, swelling and inflammation by easing out the flow of milk. It is also a common recommendation for all the new mothers to prevent mastitis.

3. C-section Incision

Infection of the stitches of your surgical incision is considered an emergency situation as it may culminate in life threatening complications like ‘burst abdomen’. If you are experiencing severe aching and stingy pain at the incision site with or without bloody or pussy discharge or infection of sutures, speak to your doctor who may change your antibiotic regimen after testing your pus sample.

4. Kidney Infections

Renal infection or infection of any other part of urinary tract often present with shaking，chills, fever, urinary urgency, frequency and burning sensation, groin or loin pain and other urinary symptoms. Once identified healthcare providers generally advice a course of antibiotics for early detection and management. Meanwhile you should maintain excellent hygiene and increase your oral intake of water for early recovery.

What to Do If You Have Postpartum Infection?

If you have developed infection or are suffering from disturbing symptoms as mentioned above, feel free to book an appointment with your healthcare provider as early as possible in order to initiate the treatment. Always remember that untreated infections take on a very serious course that makes healing very difficult.

• Take the antibiotics religiously as advised by your doctor and keep up with all your appointments.
• It is always a good idea to inform your doctor before hand that you are/ are not breastfeeding your baby as it may impact the choice of antibiotics advised by your healthcare professional.
• Increase your water intake to maintain hydration status of your body
• Even if your symptoms resolve after taking antibiotics, make sure to complete the course and get a medical evaluation at the end of regimen to confirm that infection is gone.