Postpartum Fever

Description

General measures

Medicine treatment

Referral

---

O85/O86.0-4/O86.8

DESCRIPTION

During delivery the woman's protective barrier against infections is temporarily reduced and this may lead to infections.
The cause of fever may be a serious complication.
Consider excessive use of misoprostol for PPH (doses >600 mcg) as a possible non-infectious cause of postpartum fever.

GENERAL MEASURES

Prevent deep vein thrombosis.
Complete evacuation of uterine contents.
Hysterectomy may be indicated in severe uterine sepsis.
Attention to breast engorgement.

MEDICINE TREATMENT

Antibiotic treatment, where appropriate, should be guided by the presumed source of infection.

Empiric antibiotic therapy

• Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly, until patient apyrexial for 24 hours.

LoE:IVb

Follow with:

• Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.

REFERRAL

• No clinical response in 48 hours of antibiotic treatment.

• Septic shock.

Click here to access the pdf.

---

Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2025-9 Review_Version 2.0_26 March 2026

Chapter 6 Obstetrics_6.16 Postpartum Fever