Postpartum pyrexia of unknown origin

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 such as endometritis, but there are a wide variety of other possible causes. A comprehensive history and complete physical examination should always be carried out. Although initial investigation should focus on ensuring that the genital tract has been fully assessed, including swabs and ultrasound examination, 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. 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 life saving. Early consultant involvement is important to achieve better outcomes.