Postpartum pyrexia

Postpartum pyrexia is a common condition that is sometimes associated with serious maternal morbidity and occasional mortality. Most cases are due to underlying genital tract infection, but there are a wide variety of other possible causes that may not always be clinically obvious. A comprehensive history and physical examination should always be carried out. Initial investigation should focus on thorough assessment of the genital tract, including swabs and ultrasound examination. However, a wide range of further investigations may be needed to determine the cause of the pyrexia. Use of an early warning chart for observations is important to detect early changes in a patient's condition. Serious infection can develop insidiously and patients can deteriorate very rapidly, so immediate high dose broad-spectrum intravenous antibiotic treatment without waiting for microbiology results can be lifesaving. Early recognition, consultant involvement, appropriate investigation and prompt treatment are keys to successful management.