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Pregnancy and Childbirth: The answers
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Infection risk post-delivery

 

Predisposing factors for post-delivery womb infection

Again, in most cases, there is no obvious predisposing factor. Occasionally such factors as prolonged labor, chronic under-nutrition, anemia or a weakened body immunity may be identifiable.

"Flesh-eating bug" (Group A beta-hemolytic streptococci) and postpartum infection.
Infection caused by the so-called flesh-eating bug is rare. However, when it occurs, especially if there is delay in diagnosis, it can be deadly.


When this occurs, it is usually following a cesarean section. There is slowly advancing soft tissue infection. There may be extensive tissue destruction. Treatment will involve surgical removal of this tissue as well as an aggressive antibiotic course in high doses. Fortunately, the offending bacteria (group A beta-hemolytic streptococci) respond well to antibiotics.

 

The medical term for the condition is "necrotizing fasciitis”. Sometimes other types of bacteria are to blame.

 

 

 

 

 

 

Cesarean section and postpartum infection
The fact that there is significantly more risk of infection following a cesarean section (that a vaginal delivery) is not in dispute. This is particularly the case following emergency cesarean section, which, of-course, in its strict interpretation, is neither predictable nor avoidable.

 

The higher risk of infection is there regardless of whether we are talking about womb infection, pelvic infection or urinary tract infection. This is one reason, among others, why unnecessary cesarean sections should be actively avoided.

 

The risk of infection following cesarean section can be reduced by administering preventative antibiotics just before the operation. These are given intravenously and is routine practice in virtually every obstetric unit. There is no place for oral antibiotics.

Postnatal pelvic abscess
Pelvic abscess formation postpartum is rare. Again, it is relatively more common after cesarean section when compared to vaginal delivery.
The main form of treatment is surgical drainage of the abscess. This may be complemented with antibiotics for several days.

 

Long-term consequences of a puerperal (postnatal) abscess

There is a risk of problems with future fertility and/or chronic pelvic pain. This is not because of failure to eradicate the infection. Rather, it is the aftermath of the infection, in the form of scarring and adhesions which, in the case of fertility, may affect the patency of the fallopian tubes. All this is uncommon.

 

UTI: Next page

 

Necrotizing fasciitis

A case of necrotizing fasciitis following delivery (in this case, vaginal). If you hover over the picture, you will see the large defect that resulted following debridement of the gangrenous tissue