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Puerperal infections, also known as postpartum infections, puerperal fever or childbed fever, is any bacterial infection of the female reproductive tract following childbirth or miscarriage. Signs and symptoms usually include a fever greater than , chills, lower abdominal pain, and possibly bad-smelling vaginal discharge. It usually occurs after the first 24 hours and within the first ten days following delivery. The most common infection is that of the uterus and surrounding tissues known as puerperal sepsis or postpartum metritis. Risk factors include Cesarean section, the presence of certain bacteria such as group B streptococcus in the vagina, premature rupture of membranes, and prolonged labour among others. Most infections involved a number of different types of bacteria. Diagnosis is rarely helped by culturing of the vagina or blood. In those who do not improve medical imaging may be required. Other causes of fever following delivery include: breast engorgement, urinary tract infections, infections of the abdominal incision or episiotomy, and atelectasis.〔 Due to the risks following C-section it is recommended that all women receive a preventive dose of antibiotics such as ampicillin around the time of surgery. Treatment of established infections is with antibiotics, with most people improving in two to three days. In those with mild disease oral antibiotics may be used otherwise intravenous antibiotics are recommended. Common antibiotics include a combination of ampicillin and gentamicin following vaginal delivery or clindamycin and gentamicin in those who have had a C-section. In those who are not improving with appropriate treatment other complications such an abscess should be considered.〔 In the developed world about one to two percent develop uterine infections following vaginal delivery. This increases to five to thirteen percent among those who have more difficult deliveries and fifty percent with C-sections before the use of preventative antibiotics.〔 In 2013 these infections resulted in 24,000 deaths down from 34,000 deaths in 1990. The first known descriptions of the condition date back to at least the 5th century BCE in the writings of Hippocrates. These infections were a very common cause of death around the time of childbirth starting in at least the 18th century until the 1930s when antibiotics were introduced. In 1847, in Austria, Ignaz Semmelweiss through the use of handwashing with chlorine decreased death from the disease from nearly twenty percent to two percent. ==Signs and symptoms== Signs and symptoms usually include a fever greater than , chills, low abdominal pain, and possibly bad smelling vaginal discharge.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「puerperal infections」の詳細全文を読む スポンサード リンク
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