Puerperal infection ( puerperal infection ) refers to the delivery and postpartum reproductive tract pathogen infection, caused by local and systemic inflammatory stress of. The incidence rate is 1% ~ 7.2%, is one of the four leading causes of maternal death. Puerperal morbidity ( puerperal morbidity ) refers to the delivery of 24 hours after 10 days by export table daily temperature measured 4 times, 2 times at or above 38 DEG C. Visible puerperal infection and puerperal morbidity have different meanings. Although the cause puerperal morbidity due to puerperal infection mainly, but also include postpartum reproductive tract other than infection with fever, such as urinary infection, mastitis, upper respiratory tract infection.
Puerperal infection symptoms:
In 1 acute vulvar, vaginal, cervicitis
Delivery due to perineal injury or operation is produced and lead to infection, performed for local burning, pain, tenesmus, purulent exudate stimulation induced urethral orifice painful urination, frequent urination. Wound infection, suture in tissue swelling, pinhole pus. Vaginal and cervical infection manifested as mucosal hyperemia, ulcer, purulent secretions increase, will lead to vaginal adhesions or atresia. If the deep spread, can be disseminated to uterine tissues, causing inflammation of connective tissue.
In 2 acute endometritis, uterine myositis
Pathogens by invasive placental abruption surface, diffusion into the decidua, called endometritis. Infection of invading myometrium, called uterine myositis. Endometritis associated with uterine myositis. Heavy appears the chills, fever, headache, rapid heart rate, leukocytosis, lower abdominal tenderness uneven, lochia is not necessarily more easily misdiagnosed.
In 3 acute pelvic connective tissue inflammation, acute fallopian tube inflammation
Pathogen along uterine lymph or blood of parametrial tissue, acute inflammatory reaction and the formation of inflammatory mass, at the same time affect the mesosalpinx, tube wall. If the invasion and the pelvic cavity, can also form a" frozen pelvis". Gonorrhea diplococcus along the genital tract mucosa of ascending infection, of tubal and peritoneal, abscess formation, can high fever.
In 4 acute pelvic peritonitis and diffuse peritonitis
Inflammation continues to develop, spread to the uterine serosa, pelvic peritonitis, and then developed into a diffuse peritonitis, systemic poisoning symptoms, such as fever, nausea, vomiting, abdominal distension, abdominal examination nowadays has apparent tenderness, rebound tenderness. Due to maternal abdominal wall relaxation, muscle tension is not obvious. Due to peritoneal surface inflammatory exudate, cellulose covering cause intestinal adhesion, can also be in the rectouterine pouch forming localized abscess, bowel and bladder may be affected if abscess diarrhea, tenesmus and dysuria. During the acute phase of treatment is not completely can develop into chronic pelvic inflammatory disease and lead to infertility.
5 sepsis and sepsis
When an infected thrombus shedding into the blood circulation can cause sepsis, pulmonary, cerebral, renal abscess or pulmonary embolism and death. If large numbers of bacteria into the blood circulation and reproduction form of sepsis, and can be life threatening.
6 thrombophlebitis
Fragilis and anaerobic streptococci are common pathogens. In stasis of blood flow or vein wall damage based on bacterial secretion heparin enzyme decomposition, heparin, promote coagulation. The wall of the uterus placenta infection caused by the bacterium surface pelvic thrombophlebitis. Involving the ovarian vein, uterine vein, internal jugular vein, common iliac vein and the inferior vena cava, lesions often unilateral, patients more than 1 to 2 weeks postpartum, stepson of endometrial inflammation after the onset of shivering, high fever, recurrent, lasting several weeks, not easy and pelvic connective tissue inflammation differential. Thrombophlebitis of the lower limbs, with multiple lesions in the femoral vein, vein and saphenous vein, emergence of remittent fever. Lower limbs durative ache, intravenous local tenderness or touch hard rope, the blood returning blocked, causing lower extremity edema, pale skin, commonly known as " white leg". But some light deep lesions without obvious positive signs, color Doppler ultrasound can be unearthed. Thrombophlebitis of lower extremities more secondary to pelvic thrombophlebitis or peripheral inflammation of connective tissue.