ABSTRACT
Serious postpartum infections remain a significant cause of maternal morbidity and mortality. Time of onset of symptoms may provide a clue to etiology. Infections occurring within 48 hours of delivery commonly involve the uterus and peritoneum following cesarean section, the urinary tract following catheterization, or the respiratory tract. The microorganisms responsible for early infection were frequently present or introduced at the time of delivery, and the rate of bacteremia is high. Endometritis, or infection arising from the uterine cavity, is the most common postpartum infection. Frank chorioamnionitis is an obvious antecedent of postpartum intrauterine infection, often despite intrapartum antibiotic therapy. The diagnosis of endometritis is usually based upon clinical findings. Fever is the most useful sign and should prompt a physical examination even within the first 24 hours post-partum. The patient may complain of malaise, chills, abdominal pain, or foul-smelling discharge.
