Which body system is most vulnerable to infection during the postpartum period?

Which body system is most vulnerable to infection during the postpartum period?

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August 27, 2020 | by Linda Anderson, M.D.

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Which body system is most vulnerable to infection during the postpartum period?

After having a baby, you can expect some pain and discomfort in the weeks that follow. This is normal.

Women should also be aware of the more serious complications that can happen in the 6-week period after giving birth, also known as the postpartum period.

Post-delivery complications shouldn’t be ignored. About 700 women die from pregnancy-related complications each year in the U.S., and about 3 in 5 pregnancy-related deaths could be prevented, according to the Centers for Disease Control and Prevention.

After having a baby, it’s important to be aware of postpartum complications (between birth and six weeks postpartum) and alert your doctor if you experience any of these:

  • Excessive bleeding (hemorrhage). While bleeding for about 2-6 weeks is normal after giving birth, it should begin to slow. Some women experience excessive bleeding, usually in the 1-2 weeks following delivery, which may be caused by a retained placenta, infection or other issues.
  • Infection and sepsis. Some women experience infections (uterine, urinary, wound, upper respiratory, and mastitis) after birth. When caught early, an infection can be resolved with antibiotics. However, if an infection advances and is left untreated, it can lead to sepsis, abscesses, pulmonary embolism, septic shock and more.
  • Stroke. Approximately 50% of strokes occur postpartum. The highest risk periods appear to be the delivery period and up to two weeks postpartum, but the risk can continue up to six weeks postpartum.
  • Cardiomyopathy and heart disease. Some postpartum women are at risk for peripartum cardiomyopathy, a rare type of heart failure that weakens the heart muscle and makes it harder for the heart to pump blood to the rest of the body. Some risk factors include hypertension, obesity, diabetes, malnutrition, smoking and advanced maternal age.
  • Pulmonary embolism. This is a blockage in one of the pulmonary arteries in the lungs often caused by blood clots that travel to the lungs from the legs. Some risk factors include obesity, C-section birth, prolonged labor, hypertension, dehydration, and advanced maternal age.
  • Depression and anxiety.  Perinatal mood and anxiety disorders (PMADs) affect up to 1 in 5 women during pregnancy and after giving birth. While symptoms usually resolve within a week or two after delivery, sometimes symptoms continue and worsen. Learn more about PMADs.
  • Complications related to substance use disorder. The number of drug poisoning and opioid- related maternal deaths has drastically increased in Illinois over the past several years. Between 2008 and 2016, pregnancy-associated deaths related to any drug poisoning nearly tripled and related to opioid poisoning increased almost 6-fold. Explore addiction services.

The overall risk of dying from a pregnancy-related complication is low, but women with chronic conditions, such as obesity, heart disease or high blood pressure are at greater risk.

Fortunately, many postpartum complications can be treated successfully if identified early. If you have any of the following warning signs, seek immediate help:

  • Severe bleeding that hasn’t slowed
  • Pain that increases or chest pain
  • Fever of 100.4 F or higher
  • Rapid heartbeat or palpitations
  • Shortness of breath, feeling faint upon standing
  • An incision that isn’t healing
  • A red or swollen leg that's painful or warm to the touch
  • Feelings of being cold
  • A headache that doesn’t go away, vision changes
  • Seizures
  • Thoughts of hurting yourself or your baby

It’s very important to take care of yourself, listen to your body and alert your doctor if you have any concerns.

Edward-Elmhurst Health began an initiative in our Emergency Departments to increase awareness among new moms and healthcare providers of postpartum complications that new moms can experience.

All postpartum patients receive a teal wristband (representing female strength) inscribed with “Edward-Elmhurst Health Cares About Moms” to wear until their 6-week postpartum visit. If a new mom develops physical or emotional issues during that timeframe, the bracelet can help alert emergency medicine paramedics and Emergency Department staff that she has recently given birth.

Our hospitals earned national recognition as Blue Distinction® Centers for Maternity Care. The designations signify that our maternity departments met nationally established selection criteria by demonstrating expertise in delivering quality specialty care, safely and effectively. Learn more about our quality of care.

Learn more about our pregnancy and baby services.

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Who is at risk for postpartum infection?

Conclusion Postpartum infections occur in ∼1/15 women delivering vaginally with chorioamnionitis, with those who deliver at < 32 weeks' gestation being at increased risk.

What is the most common cause of postpartum infection?

The majority of postpartum infections result from physiologic and iatrogenic trauma to the abdominal wall and reproductive, genital, and urinary tracts that occur during childbirth or abortion, which allows for the introduction of bacteria into these normally sterile environments.

Which site is the most common for postpartum infection?

“The most common ones are an infection of the uterus called endometritis, a C-section infection, and then another kind of infection that can happen, especially when someone is breastfeeding, is called mastitis, and that's an infection in the breast,” explains Sutton.

What is the major system affected during puerperium?

There are three main conditions that affect the puerperium and the urinary system: urinary retention, incontinence and diuresis. Urinary retention is common, and the bladder can easily become over-distended in days 1–2 of the puerperium. The reasons for this are physiological, neurological, and mechanical.