Abstract
A follow-up of 535 patients after vaginal delivery showed that 9% had a fever of 37·7°C or greater, and 2% had a fever of 38°C or more, on two days. The commonest cause of both categories of fever was Mycoplasma hominis infection as defined by a fourfold or greater rise in mycoplasmacidal antibody titre. Among women for whom sera were available this agent caused 50% (14/28) of all fevers and 71% (5/7) of the higher fevers. Absence or low titre (<1:8) of antibody against M. hominiswas the strongest single predictor of otherwise unexplained fever (16/40 patients with low antibody titre were febrile vs 7/50 with high antibody titre, p<0·01). Among women with absent or low antibody titres, both rise in titre of antibody to this organism and lochial colonisation by it were significantly associated with fever (p<0·001, p<0·025, respectively). Standard microbiological and clinical techniques identified probable causes in only 18% (5/28) of all fevers and 29% (2/7) of higher fevers. Patients who had postpartum infection caused by M. hominis remained in hospital 31% longer than the non-infected patients (4·57 vs 3·49 days, p<0·001). Low antibody to and lochial colonisation with M. hominisoccurred together in 17% of patients, who accounted for 71% of all higher fevers. Since these risk factors for postpartum fever can be identified before delivery, prophylactic measures applied selectively to women with these risk factors may prevent a large proportion of postpartum fevers and the excess hospital stay associated with them.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call