Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-6bf8c574d5-mcfzb Total loading time: 0 Render date: 2025-03-09T22:56:39.111Z Has data issue: false hasContentIssue false

58 - Postpartum and Postabortion Infections

from Part III - Special Populations

Published online by Cambridge University Press:  15 December 2009

By
Lisa Rahangdale
Edited by
Rachel L. Chin
Lisa Rahangdale
Affiliation:
Instructor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
Get access

Summary

INTRODUCTION – INFECTIONS AND AGENTS

Infections prevalent in the postpartum and postabortion period include urinary tract and genital tract infections (including endometritis, septic pelvic thrombophlebitis, pelvic inflammatory disease, and tubo-ovarian abscess), as well as mastitis, pneumonia (as a complication of anesthesia), and wound infection. Approximately 6% of women develop infections after vaginal delivery or cesarean section, the majority (94%) after hospital discharge. The most common postpartum infections are mastitis and urinary tract infection. This chapter reviews genital tract infections, mastitis, and episiotomy site infections. See Chapters 32, 37, and 57 for discussions of pneumonia, urinary tract infections, and surgical wound infections.

Endometritis: Postpartum and Postabortion

Endometritis is infection of the uterus. This may include the lining of the uterus (endometrium), the muscular layer (myometrium), or the entire organ. Endometritis is a polymicrobial infection occurring either at the time of delivery or during operative procedures via exposure of the upper genital tract to vaginal flora. Pathogens include aerobic and anaerobic gram-positive cocci (group A beta-hemolytic Streptococcus, coagulase-positive Staphylococcus aureus, group B Streptococcus, Streptococcus pneumoniae, and Enterococcus faecalis) as well as aerobic and anaerobic gram-negative agents (Escherichia coli, Gardnerella vaginalis, and Bacteroides fragilis). Other pathogens include those associated with prior sexually transmitted infection such as Chlamydia trachomatis and Neisseria gonorrhoeae, and those associated with bacterial vaginosis such as Mycoplasma hominis and Ureaplasma urealyticum.

Type
Chapter
Information
Emergency Management of Infectious Diseases , pp. 385 - 390
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American College of Obstetrics & Gynecology. ACOG Educational Bulletin No. 258. Breastfeeding: maternal and infant aspects. July 2000.
American College of Obstetrics & Gynecology. ACOG Practice Bulletin No. 67. Medical management of abortion. Oct 2005.
Barbosa-Cesnik, C, Schwartz, K, Foxman, B. Lactation mastitis. JAMA 2003;289(13):1609–12.CrossRefGoogle ScholarPubMed
Brown, C E, Stettler, W, Twickler, D, et al. Puerperal septic pelvic thrombophlebitis: Incidence and response to heparin therapy. Am J Obstet Gynecol 1999;181(1):143–8.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC). Clostridium sordellii toxic shock syndrome after medical abortion with mifepristone and intravaginal misoprostol – United States and Canada, 2001–2005. MMWR 2005 July 22;54(Dispatch):1.
Centers for Disease Control and Prevention (CDC). [Title]. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm54d722a1.htm.
Faro, S. Postpartum endometritis. Clin Perinatol 2005;32:803–14.CrossRefGoogle ScholarPubMed
Hopkins, L, Smaill, F. Antibiotic prophylaxis regimens and drugs for cesarean section (Review). Cochrane Library 2006;2. New York: Wiley. The Cochrane Collaboration.Google Scholar
Larson, J W, Hager, W D, Livengood, C H, et al. Guidelines for diagnosis, treatment and prevention of postoperative infections. Infect Dis Obstet Gynecol 2003; 11:65–70.CrossRefGoogle Scholar
Ledger, W J. Postpartum endomyometritis diagnosis and treatment: a review. J Obstet Gynecol Res 2003 Dec; 29(6):364–73.CrossRefGoogle Scholar
Livingston, J C, Llata, E, Rinehart, E. Gentamicin and clindamycin therapy in postpartum endometritis: the efficacy of daily dosing versus dosing every 8 hours. Am J Obstet Gynecol 2003;188(1):149–52.CrossRefGoogle ScholarPubMed
Sawaya, G F, Grady, D, Kerlikowske, K, et al. Antibiotics at the time of induced abortion: The case for universal prophylaxis based on a metaanalysis. Obstet Gynecol 1996; 87:884–90.Google Scholar
Shannon, C, Brothers, L P, Phillip, N M, et al. Infection after medical abortion: a review of the literature. Contraception 2004;70:183–90.CrossRefGoogle ScholarPubMed
Sweet, R L, Gibbs, R S. Infectious diseases of the female genital tract, 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2002.Google Scholar
Yokoe, D S, Christiansen, C L, Johnson, R, et al. Epidemiology and surveillance for postpartum infections. Emerg Infect Dis 2001 Sept–Oct; 7(5):837–41.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Postpartum and Postabortion Infections
    • By Lisa Rahangdale, Instructor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.059
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Postpartum and Postabortion Infections
    • By Lisa Rahangdale, Instructor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.059
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Postpartum and Postabortion Infections
    • By Lisa Rahangdale, Instructor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.059
Available formats
×