Puerperal fever (synonyms: puerperal fever and puerperal fever) was considered a feared disease of women in childbed since the existence of the first hospitals, and in the past, in the majority of cases, it led to the death of the affected women.
What is puerperal fever?
Among the diseases, which must be classified in the categories of infectious diseases, is puerperal fever. Another applicable name this disease is puerperal fever or puerperal fever. Typical of puerperal fever is that mothers become ill after the birth of a viable child or after a stillbirth with the symptoms that led to death in the past. Nowadays, puerperal fever is very rare and can be well treated. Puerperal fever represents blood poisoning, which was discovered by the Viennese physician Ignaz Semmelweiß. He also developed the appropriate preventive methods to avoid puerperal fever. Therefore, puerperal fever has lost its horror today.
Causes
Among the causative agents that lead to puerperal fever are microbial pathogens, the bacteria. They are carried by inadequate hygienic conditions or by inadequate hand and instrument and equipment disinfection and sterilization. Since the birth canal of women after childbirth is a large open wound, the germs that cause the disease can be introduced quite quickly. Another cause that can trigger puerperal fever includes an incomplete afterbirth. For various reasons, the placenta may not detach completely after birth, leaving remnants in the woman’s body. These act like “cadaveric poisons” due to the dying tissue and contribute to sepsis or poisoning. So-called “cadaveric toxins” are formed when organs that are no longer alive are decomposed by microorganisms and these enter the bloodstream. Cell-damaging decomposition substances are also formed, which are toxic to the body.
Symptoms, complaints and signs
Puerperal fever initially manifests itself through typical fever symptoms. Affected women usually notice an increasing feeling of illness, with complaints such as fatigue, palpitations, nausea and abdominal pain. As the disease progresses, patients experience repeated vomiting, with symptoms such as stomach pain and heartburn. In addition, there is inner restlessness and nervousness, which in severe cases can lead to a panic attack. The initial mildly elevated temperature progresses to a severe fever. At the beginning of the disease, usually only mild health problems occur. In the later stages, serious complications such as a drop in blood pressure, circulatory shock and blood poisoning can occur. Another symptom is intermittent bleeding and unpleasant-smelling bleeding. Delayed periods or absence of menstruation are also possible indications of infection. However, the disease can also progress without such signs. Some patients may experience other symptoms, always depending on existing illnesses and the severity of the fever. However, after a few days at the latest, the disease always causes severe malaise and serious discomfort, which quickly increases in intensity. In the last consequence, the fever leads to a circulatory collapse. If it is not treated or not treated sufficiently, it is almost always fatal.
Diagnosis and course
With current modern medical procedures and methods, it is no longer a problem to diagnose puerperal fever in time and treat it without lasting health consequences. In the therapy of mothers affected by puerperal fever, specialists use antibiotic drugs to bring about a decrease in inflammatory processes in the organism and inhibit the ability of the pathogens causing the disease to divide. In addition, puerperal fever can be successfully treated not only causally, but also symptomatically. In this context, anti-nausea, anti-vomiting, and anti-fever medications help women recover and convalesce quickly. It is important that women keep a close eye on themselves during the postpartum period and have themselves examined by their gynecologist. The latter often prescribes medicines that improve the involution of the uterus and its healing.
Complications
Puerperal fever can cause death of the patient in the worst case.The affected person suffers from a very high fever and usually also from severe pain in the abdomen and lower abdomen. There is also vomiting and nausea. If left untreated, puerperal fever can also cause circulatory shock, causing sufferers to faint and injure themselves in a fall. Usually, inner restlessness also occurs and patients suffer from breathing difficulties and an increased heart rate. If puerperal fever continues to go untreated, acute sepsis may occur, leading to death in most cases. The patient’s ability to cope with stress decreases considerably as a result of the disease, and the individual organs are also damaged. Without treatment, there is a significant reduction in life expectancy. Treatment of puerperal fever usually takes place through surgery or with the help of medication. This can limit the symptoms relatively well. If treated early, there is no reduction in life expectancy.
When should you see a doctor?
Women who feel excessively exhausted or ill after giving birth should definitely inform the doctor in charge. Childbirth fever is a serious condition that must be evaluated and treated immediately. If symptoms such as nausea and vomiting, fever or racing heart become apparent, a doctor must be consulted. Circulatory problems or unusually severe abdominal pain should also be clarified by a doctor in any case in order to avoid life-threatening complications. Medical advice is needed at the latest when signs of blood poisoning or impending circulatory shock are noticed. Women who have had a difficult childbirth are particularly susceptible to developing puerperal fever. A physician should monitor recovery and initiate an investigation if symptoms are mentioned. If severe pain or gastrointestinal discomfort suddenly develops, the doctor should be informed immediately. The same applies to an unusual feeling of illness that rapidly increases in intensity. The right person to contact is the clinician or a gynecologist. In case of doubt, the nearest hospital should be visited.
Treatment and therapy
In medicine, the treatment of puerperal fever is spoken of different approaches, depending on the extent of the disease. The individual procedures are divided into local and general measures. Local applications are appropriate in puerperal fever when it appears that puerpural ulcers have formed in the uterus. These are opened surgically in puerperal fever or eliminated by the specific use of caustic solutions. To stabilize the general condition of the mothers, medications that stimulate and strengthen the circulation are administered, as well as infusions if necessary. These can be purely synthetic or herbal. It is not possible to breastfeed children during puerperal fever. Despite all treatment options, it must still be assumed today that mothers with puerperal fever can die in the absence of treatment.
Outlook and prognosis
Puerperal fever is a potentially life-threatening inflammation of the uterus after childbirth. Delivery has created open wounds that can quickly become infected with invading bacteria. Because the uterus is so compromised, the immune system cannot work as quickly as the bacteria multiply, so infection can occur very quickly in unsanitary conditions. This results in blood poisoning with multiple organ failure and subsequent death. This course was unavoidable in earlier centuries, when antibiotics did not exist. Nowadays, two factors ensure that puerperal fever is no longer the most common cause of death in women immediately after childbirth. On the one hand, hygienic conditions in hospitals and clinics mean that infection of the wounded uterus no longer occurs at all. On the other hand, even in the case of infection with bacteria, there would be the possibility of admitting the woman as an inpatient and treating her with high doses of antibiotics. This would still make puerperal fever extremely unpleasant, but a fatal course can be almost ruled out in an otherwise healthy woman. The prospects for a complete cure are therefore good nowadays.It has a positive effect on the prognosis if puerperal fever is recognized as such and treated early.
Prevention
To prevent puerperal fever, it is essential to keep contaminants away from the birth wound. Appropriate hygiene in the context of surface disinfection is obligatory against puerperal fever for this purpose. In addition, doctors use only sterile instruments and wear disposable gloves. These measures apply not only to clinics but also to home births and must be observed by the assisting midwives. If midwives are assisting women who have already contracted puerperal fever, they should initially provide only limited obstetric care in order to prevent the spread of germs. Observance of the valid hygiene, disinfection, and sterilization guidelines is essential during obstetric care as prevention against puerperal fever.
Follow-up
Follow-up care is most commonly associated with tumors. Doctors hope to treat a recurrent and life-threatening disease in its early stages through a tight grid of examinations. It is true that puerperal fever can also lead to the death of the young mother. However, no further dangers exist after recovery. A recurrence of puerperal fever arises from another birth, but not from the first. Since the mother no longer has any symptoms, there is no need for follow-up care immediately after the original diagnosis. The risk of death can be prevented. The responsibility for this lies with the nursing staff. On the one hand, sufficient hygienic standards ensure that an illness does not develop in the first place. On the other hand, antibiotics realize a cure. In Western industrialized countries, obstetricians are aware of the risk of puerperal fever. They take care to prevent complications from occurring in the first place. As a result, they provide the actual follow-up care. Other areas of aftercare can generally be in everyday support and therapeutic ongoing treatment. However, neither of these aspects come into play in the case of puerperal fever. Antibiotics allow for a complete recovery. The young mother no longer feels any suffering and can continue her life without worry.
This is what you can do yourself
For a long time, puerperal fever was one of the most common causes of death in women of childbearing age. In the meantime, the causes are known and preventive measures as well as therapeutic methods have been developed to effectively combat this disease. Nevertheless, the disease can still be fatal. Women who observe symptoms of puerperal fever in themselves after childbirth must seek medical treatment without fail. Self-treating the symptoms is life-threatening. Puerperal fever is manifested by increased temperature, nausea and vomiting, and abdominal pain. In severe cases, there is even a risk of blood poisoning or circulatory shock. However, a patient should not let it get that far and should attend all recommended follow-up examinations after the birth. In this way, incipient infections can be detected and treated at an early stage. In addition, prevention is very important. When choosing a maternity hospital, women who are forced to give birth outside a Western industrialized country should make absolutely sure that modern hygiene standards are observed and also explicitly ask the staff about this. In the case of a home birth, it is essential to check the midwife’s hygiene standards. Patients should calmly ask which disinfectant is used for their hands and have it shown to them during a preliminary examination. If acute puerperal fever has occurred, it is essential that patients take it easy. Under no circumstances should an attempt be made to breastfeed the newborn during this time.
