Flashcards in Postpartum Endomyometritis Deck (9)
Endomyometritis – etiology? Best therapy?
Ascending infection of vaginal organisms (anaerobic predominance)
Gentamicin + clindamycin
Endomyometritis? When to suspect it?
Infection of the decidua, myometrium, and sometimes parametrial tissues
Fever 2 days after C-section
Septic pelvic thrombophlebitis
Bacterial infection of pelvic venous thrombi, usually involving ovarian vein
After anabiotic treatment, fever resolves when? If no resolution, suspect? Treatment? If still no resolution, management?
Enterococcal infection – add ampicillin
CT scan of abdomen and pelvis (looking for abscess or infected hematoma)
Other possible cause of fever after C-section? Occurs when?
Wound infection. Postoperative day 4
Treatment for wound infection?
Surgical opening of wound (Examine for necrotizing fasciitis)
Add antimicrobial agents,
Signs of septic pelvic thrombophlebitis? Mechanism? Confirm diagnosis with? Treatment?
1. Hectic fever but well appearing
2. Palpable pelvic mass
Infection at public implantation site spreads to ovarian venous plexus
Antimicrobial therapy and heparin
Patient with postpartum fever – rule out?
1. Pulmonary – cough/atelectasis?
2. Pyelonephritis – CVA tenderness/dysuria?
3. Mastitis – breast engorgement/tenderness?
4. wound infection – induration/erythema/drainage?
5. Endometritis – tender/foul-smelling lochia?