Severe postpartum endometritis

Question 1

clinical picture considered to be severe postpartum endometritis?

Answer 1

• 48 hrs of fever (above 38 C) despite abx

Question 2

what other diagnoses to consider?

Answer 2

• retained products
• abscess
• GI: appendicits, pancreatitis, cholecystitis, pyelonephritis
• infected hematoma
• septic pelvic thrombophlebitis

Question 3

what microbiology should you consider?

Answer 3

• group A Strep (watch out for toxic shock syndrome, nec fasc)
• mycoplasma
• ureaplasma
• HSV
• ureaplasma