Puerperal Sepsis
Description General measures Medicine treatment Referral O85/O86.0-4/O86.8 DESCRIPTION Clinical features include a temperature ≥ 38°C (usually ≥ 2 days after delivery), often accompanied by offensive vaginal discharge (lochia) and/or abdominal pain within the first 10 days postpartum. In post caesarean section (CS) cases, there may additionally be tenderness around the CS wound and offensive
Description
General measures
Medicine treatment
Referral
O85/O86.0-4/O86.8
DESCRIPTION
Clinical features include a temperature ≥ 38°C (usually ≥ 2 days after delivery), often accompanied by offensive vaginal discharge (lochia) and/or abdominal pain within the first 10 days postpartum. In post caesarean section (CS) cases, there may additionally be tenderness around the CS wound and offensive discharge from the wound.
GENERAL MEASURES
- Monitor vital parameters, e.g. Hb, pulse, BP, temperature.
- Treat for shock if indicated.
MEDICINE TREATMENT
- Ceftriaxone, IV, 1 g as a single dose.
CAUTION: USE OF CEFTRIAXONE
Do not administer calcium-containing fluids, e.g. Ringer-Lactate, concurrently with ceftriaxone.
AND
- Metronidazole, oral, 400 mg as a single dose.
REFERRAL
All cases.
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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026
Chapter 6: Obstetrics and Gynaecology_6.7.2 Puerperal Sepsis
Drugs mentioned
ICD-10 codes
- O85Puerperal sepsis
- O86.0Infection of obstetric surgical wound
- O86.1Other infection of genital tract following delivery
- O86.2Urinary tract infection following delivery
- O86.3Other genitourinary tract infections following delivery
- O86.4Pyrexia of unknown origin following delivery
- O86.8Other specified puerperal infections