ABSTRACT
Puerperal fever was one of the commonest causes of maternal death before the concept of antisepsis and introduction of antibiotics. Hospital-acquired infections are increasing and all hospitals have strict antisepsis protocols which involve careful hand-washing and disinfection with alcohol before and after contact with patients. Early involvement of microbiologists can be invaluable in seriously ill patients and in those who fail to respond to conventional antibiotics. Endometritis in the presence of retained products of conception on ultrasonography warrants timely uterine evacuation. Inspection of the abdominal wound for swelling, discharge, and cellulitis is important in the postpartum period. In cases of discharge from the wound, swabs for bacterial culture should be undertaken followed by the commencement of broad-spectrum antibiotics. Examination of the perineum and wound swabs before antibiotic therapy in women with puerperal pyrexia is equally important. Inflammatory changes are easily treated with frequent breast emptying; infectious processes require antibiotics.
