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VIII.113 - Puerperal Fever

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Historically the terms puerperal fever and childbed fever referred to any acute fever occurring in puerperae during the first few days after delivery. Less frequently, the terms were also applied to symptomatically similar diseases that occurred during pregnancy or even among the newborn. From a modern point of view, what was formerly called puerperal fever includes a range of disorders most of which would now be referred to as puerperal sepsis. Typically, puerperal sepsis involves postpartum infection in the pelvic region, but it can refer to disorders focused in other areas, such as mastitis. In modern usage, the term puerperal fever occurs mainly in discussions of the great fever epidemics that afflicted maternity clinics in earlier centuries.

Etiology and Epidemiology

A wide range of aerobic and anaerobic microorganisms have been associated with acute pelvic inflammation and with other postpartum inflammations that could be identified as puerperal fever. Group A streptococci (pyogenes) were probably the leading causal agent in most puerperal fever epidemics in earlier centuries. However, since the 1970s, group B streptococci (agalactiae) have become the most prevalent causal agent.

Clinical Manifestations and Pathology

Among puerperae the clinical manifestations of puerperal sepsis include acute fever, profuse lochial flow, and an enlarged and tender uterus. Onset is generally between 2 and 5 days after delivery. Normally there is inflammation of the endometrium and surrounding structures as well as of the lymphatic and vascular systems. One also finds pelvic cellulitis, septic pelvic thrombophlebitis, peritonitis, and pelvic abscesses. Among neonates, infection usually becomes apparent in the first 5 days after birth, but onset is sometimes delayed by several weeks. Symptoms include lethargy, poor feeding, and abnormal temperature. Infection by group B streptococci is often clinically indistinguishable from other bacterial infections.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Carter, K. Codell. 1985. Ignaz Semmelweis, Carl Mayrhofer, and the rise of germ theory. Medical History 29.CrossRefGoogle ScholarPubMed
Charles, David, and Larsen, Bryan. 1986. Streptococcal puerperal sepsis and obstetric infections: A historical perspective. Reviews of Infectious Diseases 8.CrossRefGoogle ScholarPubMed
Eickhoff, Theodore C., et al. 1964. Neonatal sepsis and other infections due to group B beta-hemolytic streptococci. New England Journal of Medicine 271.CrossRefGoogle ScholarPubMed
Lancefield, Rebecca Craighill. 1933. A serological differentiation of human and other groups of hemolytic streptococci. Journal of Experimental Medicine 57.CrossRefGoogle ScholarPubMed
Mayrhofer, Carl. 1865. Zur Frage nach der Aetiologie der Puerperalprozesse. Monatsschrift für Geburtskunde und Frauenkrankheiten 25.Google Scholar
Pasteur, Louis. 1880. De l’extension de la théorie des germes à l’étiologie de quelques maladies communes. Comptes rendus hebdomadaires des séances de l’Académie des Sciences 90.Google Scholar
Peckham, C. H. 1935. A brief history of puerperal infection. Bulletin for the History of Medicine 3.Google Scholar
Russell, J. K. 1983. Maternal mortality in obstetrical epidemiology, ed. Barron, S. L. and Thomson, A. M.. London.Google Scholar
Semmelweis, Ignaz. 1983. The etiology, concept and prophylaxis of childbed fever, trans. Carter, K. Codell. Madison, Wis. (Originally published in German in 1861).Google Scholar

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  • Puerperal Fever
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.175
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  • Puerperal Fever
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.175
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Puerperal Fever
  • Edited by Kenneth F. Kiple, Bowling Green State University, Ohio
  • Book: The Cambridge World History of Human Disease
  • Online publication: 28 March 2008
  • Chapter DOI: https://doi.org/10.1017/CHOL9780521332866.175
Available formats
×