The key difference between puerperal pyrexia and puerperal sepsis is that puerperal pyrexia is the presence of a fever that is greater than 38°C in a woman within six weeks after giving delivery to a baby, while puerperal sepsis is the genital tract infection in a woman that occurs at any time between the rupture of membranes and 42 days postpartum.
Postpartum complications occur after childbirth. These health problems may be life-threatening and can happen for weeks and months afterward. Some examples of postpartum complications include puerperal pyrexia, puerperal sepsis, cardiovascular disease, haemorrhage, thrombotic pulmonary embolism, stroke, high blood pressure, amniotic fluid embolism, and anaesthesia complications.
CONTENTS
1. Overview and Key Difference
2. What is Puerperal Pyrexia
3. What is Puerperal Sepsis
4. Similarities – Puerperal Pyrexia and Puerperal Sepsis
5. Puerperal Pyrexia vs Puerperal Sepsis in Tabular Form
6. Summary – Puerperal Pyrexia vs Puerperal Sepsis
What is Puerperal Pyrexia?
Puerperal pyrexia is defined as the presence of a fever greater than 38°C in a woman within six weeks after delivering a baby. The specific causes of puerperal pyrexia may include urinary tract infections (E. coli, Proteus spp., Klebsilla spp.), genital tract infections (E. coli, Streptococcus, Staphylococcus, Clostridium welchii), mastitis (Staphylococcus spp.), postoperative infection following caesarean section, deep vein thrombosis, or other infections (viral or chest infection and Glandular fever). The signs and symptoms of puerperal pyrexia include pyrexia (greater than or equal to 38°C), sustained tachycardia, breathlessness, abdominal or chest pain, diarrhoea or vomiting (due to endotoxins), uterine angle pain and tenderness, and generally unwell, anxious or distressed appearance.
Moreover, puerperal pyrexia can be diagnosed through physical examination (examination of temperature, blood pressure, tenderness in uterine, breathing, chest infection, abdomen and leg thromboses), vaginal swab, uterine culture, microscopy, throat swabs, full blood count (FBC), blood culture, ultrasound scan, and sputum culture. Furthermore, treatment options for puerperal pyrexia may include ice packs for pain from perineal wounds or mastitis, rest and adequate fluid intake, administration of intravenous broad-spectrum antibiotics, analgesia, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous immunoglobulins (IVIg,) and surgical intervention (incised abscess and drainage).
What is Puerperal Sepsis?
Puerperal sepsis is a genital tract infection in women that occurs at any time between the rupture of membranes and 42 days postpartum. Approximately 75000 women die annually by puerperal sepsis worldwide. In the UK, puerperal sepsis remains an important cause of maternal death. The mortality rate in the UK by puerperal sepsis was 0.44 deaths per 100,000 maternities in 2015 – 2017.
The signs and symptoms of puerperal sepsis may include pelvic pain, fever, bleeding, abnormal foul-smelling vaginal discharge, and delay in the reduction of the size of the uterus. Moreover, puerperal sepsis is caused by genital tract infection of pathogens that colonise the cervix vagina. After infection, these pathogens gain access to amniotic fluid and invade the devitalised uterine tissues. Examples of these pathogens are bacteria like Streptococci spp., Staphylococcus spp. (Staphylococcus aureus), Escherichia coli, Clostridium tetani, Clostridium welchii, Chlamydia spp., Gonococcus spp., Klebsiella spp., Pseudomonas and Enterococci.
Puerperal sepsis can be diagnosed through physical examination (examine temperature, pain, bleeding, foul-smelling vaginal discharge) and blood tests (white blood cell count). Furthermore, treatment options for puerperal sepsis may include broad-spectrum antibiotics intravenously and oral intake of antibiotics such as ampicillin and gentamicin with metronidazole clindamycin.
What are the Similarities Between Puerperal Pyrexia and Puerperal Sepsis?
- Puerperal pyrexia and puerperal sepsis are two types of postpartum complications.
- Both conditions occur in women who give birth.
- Both conditions occur during or after about six weeks after childbirth.
- They can be caused by infection by bacteria.
- Both conditions can be diagnosed through physical examination.
- They can be treated through broad-spectrum antibiotics.
What is the Difference Between Puerperal Pyrexia and Puerperal Sepsis?
Puerperal pyrexia is the presence of fever greater than 38°C in a woman within six weeks after giving delivery to the baby, while puerperal sepsis is the genital tract infection in a woman that occurs at any time between rupture of membranes and 42-day postpartum. Thus, this is the key difference between puerperal pyrexia and puerperal sepsis. Furthermore, puerperal pyrexia is caused by urinary tract infections (E. coli, Proteus spp., Klebsilla spp.), genital tract infections (E. coli, Streptococcus, Staphylococcus, Clostridium welchii), mastitis (Staphylococcus spp.), postoperative infection following caesarean section, deep vein thrombosis, or other infections (viral or chest infection and Glandular fever). On the other hand, puerperal sepsis is caused by genital tract infection of pathogens such as bacteria like Streptococci spp., Staphylococcus spp. (Staphylococcus aureus), Escherichia coli, Clostridium tetani, Clostridium welchii, Chlamydia spp., Gonococcus spp., Klebsiella spp., Pseudomonas and Enterococci.
The below infographic presents the differences between puerperal pyrexia and puerperal sepsis in tabular form for side-by-side comparison.
Summary – Puerperal Pyrexia vs Puerperal Sepsis
Puerperal pyrexia and puerperal sepsis are two different types of postpartum complications. Both these conditions occur during or after about six weeks after childbirth. However, puerperal pyrexia is the presence of fever which is greater than 38°C in a woman within six weeks after giving delivery to the baby, while puerperal sepsis is the genital tract infection in a woman that occurs at any time between rupture of membranes and 42-day postpartum. So, this is the key difference between puerperal pyrexia and puerperal sepsis.
Reference:
1. Willacy, Hayley. “Puerperal Pyrexia. Information about Puerperal Pyrexia.” Patient.info, 20 Mar. 2020.
2. Demisse, Getu Alemu, et al. “Determinants of Puerperal Sepsis among Post Partum Women at Public Hospitals in West Shoa Zone Oromia Regional State, Ethiopia (Institution Basedcase Control Study) – BMC Pregnancy and Childbirth.” BioMed Central, BioMed Central, 18 Mar. 2019.
Image Courtesy:
1. “High fever with thermometer showing a body temperature above 40°C” By Ivan Radic (CC BY 2.0) via Flickr
2. “A Woman Holding Her Head” (CC0) via Pexels