obsolete Major puerperal infectious disease

Puerperal Endometritis: A Severe Infection in Postpartum Women

Puerperal endometritis, also known as postpartum endometritis, is a severe and potentially life-threatening infection that can occur in women after childbirth. This condition was once a major cause of maternal morbidity and mortality.

Causes and Symptoms

Puerperal endometritis is caused by an infection of the decidua, which is the lining of the uterus. The symptoms of this condition can develop rapidly, causing acute abdominal pain, fever, and debility [2]. In severe cases, it can lead to sepsis, a life-threatening condition that requires urgent medical attention.

Historical Significance

In the past, puerperal endometritis was a major cause of epidemic puerperal fever, which was responsible for significant morbidity and mortality among postpartum women [5]. The streptococcus bacterium was once a leading cause of this infection, but with advancements in medicine, its incidence has decreased significantly.

Current Status

While puerperal endometritis is still a serious condition, its incidence has declined due to improved hygiene practices and the use of antibiotics. However, it remains an important consideration for healthcare providers, particularly in resource-limited settings where access to medical care may be limited [12].

References:

• [2] C HALLETT · 2005 · Cited by 77
• [5] by J Wells
• [12] Bacterial infections during labour and the puerperium are among the leading causes of maternal mortality worldwide...

Based on the provided context, it appears that there are several signs and symptoms associated with major puerperal infectious diseases.

Common Signs and Symptoms

• Fever [4][9]
• Pelvic pain [4][8][9]
• Abnormal or foul-smelling lochia [4][13]
• Mild or severe abdominal pain [13]

These symptoms can vary depending on the type and severity of the infection. It's essential to note that these signs and symptoms may not be exhaustive, and other symptoms may also be present.

Additional Symptoms

• Uterine tenderness [8][13]
• Vaginal bleeding [13]
• Foul-smelling discharge [4]

It's crucial to seek medical attention if you experience any of these symptoms, especially if they worsen over time or are accompanied by other concerning signs.

Risk Factors

• Previous C-section, especially an unplanned one [14]
• Unusual discomfort or pain that gets worse instead of better [14]

Being aware of these risk factors can help you take necessary precautions and seek medical attention promptly if symptoms arise.

Prevalence

• Postpartum infections affect approximately 5 to 7% of women during the six weeks following delivery [15]
• Puerperal sepsis is one of the top causes of maternal morbidity and mortality worldwide [15]

These statistics highlight the importance of addressing puerperal infectious diseases promptly and effectively.

References:

[4] - Symptoms of infection include a purulent or yellowish coating on the nipples. [8] - The diagnosis is therefore usually based on clinical signs and symptoms including fever, leukocytosis, lower abdominal pain, uterine tenderness, and foul-smelling discharge. [9] - infectious morbidity, puerperal sepsis, local discomfort, sexual ... sign of severe pelvic infection when left untreated, unnecessary exposure of ... [13] - Common signs and symptoms of puerperal infections may include: Fever; Uterine tenderness; Vaginal bleeding; Foul-smelling lochia; Mild or severe abdominal pain [14] - Know the symptoms — and your risk factors. Keep in mind that you’re more prone to infection if you’ve undergone a C-section, especially an unplanned one. [15] - Maternal morbidity and mortality are global socioeconomic and healthcare burdens, and postpartum infections account for a significant, and often preventable, portion of that burden.

Based on the provided context, it appears that there are several diagnostic tests that were once used to diagnose major puerperal infectious diseases, but may have become obsolete or less relevant over time.

• Physical examination: According to search result 1, a physical exam by a doctor can diagnose postpartum infections primarily through a review of risk factors and checking for fever, pain, bleeding, and foul odor. This suggests that a thorough physical examination is still an essential diagnostic tool for puerperal infectious diseases.
• Laboratory tests: Search results 7 and 8 mention laboratory tests as a necessary step in diagnosing infections, particularly in cases of aggressive soft tissue infections or severe pain and fever. However, it's unclear which specific tests are being referred to.
• Imaging tests: Search result 8 also mentions imaging tests such as ultrasound or computed tomography (CT) scans may be used in some cases.

However, other search results suggest that certain diagnostic tests have become less relevant over time:

• Automated screening of ambulatory records (search result 9): This method was found to be a sensitive way to identify postpartum infections, but it's unclear if this is still a widely used practice.
• CA125 levels in predicting laparoscopically confirmed salpingitis (search result 12): This study suggests that CA125 levels may not be a reliable predictor of salpingitis, which could indicate that certain diagnostic tests have become less relevant.

It's also worth noting that search results 10 and 13 mention puerperal infections as a whole, but do not specifically discuss diagnostic tests. Search result 14 discusses the search strategy used to identify infectious syndromes in Africa, Asia, India, Thailand, and Bangladesh, but does not provide information on specific diagnostic tests.

Overall, while some diagnostic tests may have become obsolete or less relevant over time, physical examination and laboratory tests remain essential tools for diagnosing puerperal infectious diseases. However, further research is needed to determine the current relevance of these tests in clinical practice.

References:

• Search result 1: A doctor's evaluation can diagnose postpartum infections primarily through a review of risk factors and checking for fever, pain, bleeding, and foul odor [1].
• Search result 7: Laboratory tests should be performed in patients with aggressive soft tissue infections or in patients with severe pain and fever who appear toxic [7].
• Search result 8: Imaging tests such as ultrasound or computed tomography (CT) scans may be used in some cases to diagnose puerperal infectious diseases [8].
• Search result 9: Automated screening of ambulatory records was a sensitive method for identifying postpartum infections, but it's unclear if this is still a widely used practice [9].
• Search result 12: CA125 levels may not be a reliable predictor of salpingitis [12].

Treatment of Puerperal Infections

Puerperal infections, also known as postpartum infections, are a serious complication that can occur after childbirth. The treatment of these infections has evolved over time, and while some treatments may be considered obsolete, others remain effective.

• Antibiotics: Antibiotics are the mainstay of treatment for puerperal infections. They help to eliminate the bacterial infection and prevent further complications.
  • According to search result [5], once a postpartum infection is diagnosed, administration of antibiotics is the mainstay of treatment.
  • Search result [8] states that treatment of established infections is with antibiotics, with most people improving in two to three days.
• Pain medications: Pain medications are also important for patients experiencing discomfort due to puerperal infections.
  • As mentioned in search result [3], pain medications also are important, because patients often have discomfort.

Obsolete Treatments

While some treatments may be considered obsolete, it's essential to note that they were once used and may still be referenced in older medical literature. These include:

• Surgical interventions: In the past, surgical interventions such as drainage of abscesses or debridement of infected tissues may have been performed.
  • However, with advancements in antibiotic therapy, these surgical interventions are now rarely necessary.

Current Recommendations

The World Health Organization (WHO) has provided guidelines for the prevention and treatment of maternal peripartum infections. These recommendations emphasize the importance of antibiotics in treating puerperal infections.

• Routine antibiotic prophylaxis: WHO recommends routine antibiotic prophylaxis for women undergoing operative vaginal birth.
  • As stated in search result [10], this recommendation is part of the WHO guidelines for prevention and treatment of maternal peripartum infections.

In conclusion, while some treatments may be considered obsolete, antibiotics remain the primary treatment for puerperal infections. Pain medications are also essential for managing discomfort associated with these infections.

Puerperal Sepsis and Endometritis: A Review of Differential Diagnoses

Puerperal sepsis, also known as postpartum metritis or endometritis, is a major cause of maternal morbidity and mortality worldwide. The differential diagnosis for puerperal infections includes several conditions that can mimic the symptoms of puerperal sepsis.

Common Differential Diagnoses:

• Wound Infections: Wound infections are a common differential diagnosis for puerperal sepsis, particularly in cases where there is a history of surgical intervention during delivery.
• Genital Tract Infections: Genital tract infections, such as pelvic inflammatory disease (PID), can also be considered in the differential diagnosis of puerperal sepsis.
• Mastitis and Breast Abscesses: Mastitis and breast abscesses are other conditions that can be included in the differential diagnosis of puerperal sepsis, particularly in cases where there is a history of breastfeeding.

Less Common Differential Diagnoses:

• Voiding Difficulty and Urinary Retention: Voiding difficulty and urinary retention can also be considered in the differential diagnosis of puerperal sepsis, particularly in cases where there is a history of urinary tract infections.
• Symptomatic Hemorrhoids: Symptomatic hemorrhoids can also be included in the differential diagnosis of puerperal sepsis, particularly in cases where there is a history of anal or rectal symptoms.

Other Conditions to Consider:

• Infectious Diseases in Obstetrics and Gynecology: Other conditions that should be considered in the differential diagnosis of puerperal sepsis include infectious diseases in obstetrics and gynecology, such as PID and endometritis.
• Non-Infectious Diseases in the Puerperium: Non-infectious diseases in the puerperium, such as hypertensive disorders and thrombosis/embolism, should also be considered in the differential diagnosis of puerperal sepsis.

References:

• [1] Puerperal infection is a major cause of maternal morbidity and mortality worldwide. (Source: [11])
• [2] Wound infections are a common differential diagnosis for puerperal sepsis, particularly in cases where there is a history of surgical intervention during delivery. (Source: [13])
• [3] Genital tract infections, such as pelvic inflammatory disease (PID), can also be considered in the differential diagnosis of puerperal sepsis. (Source: [12])

References:

[1] Puerperal infection is a major cause of maternal morbidity and mortality worldwide. (Source: [11]) [2] Wound infections are a common differential diagnosis for puerperal sepsis, particularly in cases where there is a history of surgical intervention during delivery. (Source: [13]) [3] Genital tract infections, such as pelvic inflammatory disease (PID), can also be considered in the differential diagnosis of puerperal sepsis. (Source: [12])