Increased temperature in the puerperium | Increased temperature

Increased temperature in the puerperium

Elevated temperatures in the puerperium, also called postpartum fever or puerperal fever, are an expression of an infection of the female reproductive organs after birth, usually caused by the penetration of bacteria via the birth wound. In most cases, bacteria rise from the vagina into the uterus and cause an inflammation there or even on the fallopian tubes and ovaries. In addition to increased temperatures, there is then also a pressure pain in the lower abdomen, foul-smelling postpartum and circulatory problems. This disease is promoted by vaginal deliveries, caesarean sections, premature rupture of the bladder, the remaining remains of a patch or a congestion of the lochia.

Causes

An elevated body temperature can have many causes. It is noticeable that small children have raised temperatures or fever much more often than adults. One reason for this is that the immune system of small children is not yet fully mature and therefore bacteria or viruses lead to infections much more frequently.

This does not mean, however, that every increase in the child’s temperature is synonymous with an infection (e.g. middle ear infection, flu, gastrointestinal infections, etc.). For example, a rise in temperature or fever can also occur if the child’s teeth come out or simply because he or she has been playing around a lot or has put on too warm clothes.

• Cause postoperative fever: In many cases, after major surgery, the temperature rises in the first 10 days after surgery.

  This is due to the physiological reaction of the body to the body structures injured by the operation and to any foreign body material used (e.g. wires, sutures, etc.). However, if the temperature rises to the range of the fever, this can also be an indication of existing postoperative infections (e.g. wound infections).

• Environmental influences: Very high outside temperatures and direct, strong sunlight on the body can also lead to an increased temperature.This can even trigger a life-threatening heat stroke (overheating of the body to over 40°C with subsequent brain edema or brain damage).
• Infections: Of course, bacterial or viral infections are also always a possibility, in which the body supports the immune system through increased temperatures and makes the pathogen defence more efficient. As a rule, the fever is higher with bacterial infections than with viral ones.
• Allergies: But also in the context of allergic reactions (e.g.

  hay fever, pollen allergy, reaction to food or medication) an increased temperature can occur.

• Diseases of the immune system: In the same way, rheumatic diseases and autoimmune diseases, in which the immune system recognizes and attacks the body’s own structures as foreign, can have fever as an accompanying symptom.
• Cause Stress: Other circumstances that can cause an increased body temperature are increased stress or the intake of certain medications (e.g. antibiotics such as ampicillin, cephalosporins, vancomycin; tricyclic antidepressants, atropine, etc. ).
• Tumor as cause: A very rare cause of an increased temperature over a longer period of time can be an existing tumor. If the elevated temperature also occurs together with unintentional weight loss and night sweats (so-called B-symptoms in tumor diseases), a general check-up for possible tumor diseases is advisable.
• Unclear cause: If elevated temperatures or even a fever above 38.5°C exist for a period of at least 3 weeks without any cause being found by medical diagnosis, this is called a fever of unclear origin.

One of the physiological causes of slight temperature fluctuations or increases are differences in the body’s metabolic activity during the course of the day.

This leads to the fact that the body core temperature is physiologically lower, for example, at night than during the day, reaches its lowest point in the second half of the night and in the morning, and reaches its highest value in the afternoon or early evening. Depending on the time of the temperature measurements, normal temperature fluctuations can therefore be interpreted as increased temperature. In the same way, temperatures can also vary slightly from one place to another within the body.

For example, if the temperature is not always measured at the same place, the readings may differ. Physiological body temperature fluctuations in women include the slight elevated temperature in the second half of the cycle shortly after ovulation, which remains until before the start of the next period. This is a difference of about 0.2-0.5°C (e.g. from 36.5 to 37°C) caused by the increase in the hormone progesterone. The same applies in the case of an existing pregnancy, in which a constant temperature increase of up to 0.5°C occurs due to the permanent progesterone increase. If, however, a more pronounced increase in temperature or even fever occurs during pregnancy, it is advisable to consult your gynaecologist immediately in order to rule out possible complications during pregnancy.