Postpartum Infection

Excerpt

Pregnancy-related morbidity and mortality are global socioeconomic and healthcare burdens, and postpartum infections account for a significant and often preventable portion of that burden. The postpartum period is traditionally defined as the 6 weeks following delivery, and infections are relatively common, affecting an estimated 5% to 7% of patients during this time. Puerperal sepsis is one of the top 5 causes of pregnancy-related deaths worldwide and accounts for 10% to 15% of deaths in the postpartum period.

In the United States, sepsis complicates 4 in 10,000 live births, but it is the second leading cause of peripartum death. Rates of postpartum sepsis continue to increase. In over 60% of these cases, delays in recognition or management occur, and an estimated 63% of parental deaths from sepsis may have been prevented. Infections are also the most common cause of death following spontaneous or induced abortions. The medical burden of these infections is compounded by the alarmingly rapid increase in bacterial resistance to commonly used antibiotics.

Postpartum infections also present a significant social burden as they increase parental anxiety, the risk of postpartum depression, interfere with bonding, and can negatively impact breastfeeding. Postpartum infections discussed in this course include infections that occur after live births, stillbirths, and spontaneous or induced abortions. Mastitis is not included in this discussion, as it does not directly result from pregnancy or delivery.