What is Puerperal Fever?

Also known as childbed fever, puerperal fever is a condition that can develop into puerperal sepsis. This is a serious form of septicemia that is most often contracted after an abortion, miscarriage, or childbirth. Women who have cesarean births are at a higher risk of contracting puerperal sepsis or fever than those who deliver vaginally, however.

Puerperal fever is diagnosed when a woman shows a temperature above 100.4° (38°C) over 24 hours or recurring from the end of the first to the end of the tenth postpartum day. An oral temperature of 100.4° F(38°C) or more on any two of the first ten days postpartum is also a warning sign. Some patients may report a headache, vomiting, trouble breathing, diarrhea, sore throat, or unusual vaginal discharge as well. If caught early, this condition can be treated with antibiotics. When it develops into puerperal sepsis, however, the condition can lead to toxic shock syndrome, multi-organ failure, and death.

Commonly, genital tract sepsis is the infection responsible for puerperal fever. Unsanitary environments can cause the spread of the condition, although some cases are naturally caused by Group A Streptococcus and Group B Streptococcus bacterium.

Historically, puerperal fever was a severe danger for pregnant women. In the 18th and 19th centuries, it was second only to tuberculosis as the leading cause of death for all women of childbearing age. The condition was also listed as the most common cause of maternal mortality. The spread of this condition was largely due to a lack of knowledge about the importance of a sterile hospital environment. In fact, doctors would often deliver multiple babies on the same day without washing their hands or changing their clothes in between appointments.

After the importance of antiseptic techniques became widely understood in the 20th century, maternal deaths from puerperal fever dropped dramatically. In the United States today, the condition is relatively uncommon. However, about 3 in 100,000 women still die from puerperal sepsis each year. Victims come from a variety of backgrounds, so even young and fit mothers with strong immune systems are at risk. Understanding how to recognize the warning signs of puerperal fever and when to seek medical attention is critical.