Obgyn: Puerperal Pyrexia: Free MSRA Podcast

🎙️ FREE MSRA PODCAST – Puerperal Pyrexia (Postpartum Fever)💡 A complete, high-yield breakdown of puerperal pyrexia – essential for the MSRA and clinical practice.🧠 Key Learning Points📌 Definition• Fever ≥38°C on any 2 of the first 10 days postpartum (excluding first 24 hrs)• A red flag for infection after childbirth• Prompt recognition is vital to prevent complications like sepsis📌 Common Sources🦠 Endometritis (uterine lining infection)🦠 UTI (e.g. E. coli)🦠 Mastitis (breast infection)🦠 C-section or episiotomy wound infections🦠 Respiratory tract (e.g. pneumonia)🦠 DVT or thrombophlebitis🧬 Non-infectious: Retained products, VTE, atelectasis📌 Risk Factors🔺 Caesarean section🔺 Prolonged labour🔺 Premature rupture of membranes🔺 Multiple vaginal exams🔺 Poor perineal hygiene🔺 Diabetes, anaemia, obesity, immunosuppression🔺 Instrumental delivery or trauma🧠 Mnemonic: “4Ps + DIM” (Prolonged labour, PROM, Perineal issues, Procedures + Diabetes, Immunosuppression, Multiple risk factors)📌 Symptoms & Signs• Fever, chills, malaise• Abdominal or uterine tenderness• Foul-smelling lochia (suggests endometritis)• Dysuria (suggests UTI)• Breast pain/redness (mastitis)• Wound discharge or erythema📌 Differentials🧐 UTI🧐 Mastitis🧐 Pneumonia🧐 Wound infections🧐 Retained products🧐 VTE or atelectasis→ Think broadly: not all postpartum fevers are due to infection!📌 Investigations🔬 Bloods: FBC, CRP, cultures🔬 Urine culture🔬 Vaginal/wound swabs🔬 Ultrasound: retained products or abscess🔬 Chest X-ray if respiratory symptoms🔬 Consider D-dimer or leg Doppler if suspecting DVT📌 Red Flags – URGENT Referral🚨 Fever >38°C + one of:• Persistent tachycardia (>90 bpm)• RR >20• Severe pain (abdomen/chest)• Diarrhoea/vomiting• Signs of sepsis or shock🔑 Sepsis = medical emergency📌 Management💊 Empirical IV antibiotics (e.g. piperacillin-tazobactam ± clindamycin)💊 Tailor once cultures return⛔ Avoid NSAIDs in suspected Group A strep🧪 IVIG in severe cases (e.g. toxic shock)🗡️ Surgery if abscess or retained products🩺 Supportive: fluids, analgesia, early mobilisation📌 Complications☠️ Sepsis (20–60% mortality if untreated)⚠️ Pelvic abscess⚠️ Wound dehiscence⚠️ DVT⚠️ Postpartum depression⚠️ Long-term infertility or renal damage if untreated📎 Puerperal Pyrexia MSRA Resources📝 Revision Notes: https://www.passthemsra.com/topic/puerperal-pyrexia-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/puerperal-pyrexia-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/puerperal-pyrexia-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/puerperal-pyrexia-rapid-quiz/🎓 Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/🧪 Quiz Link: https://www.passthemsra.com/quizzes/puerperal-pyrexia/🔍 Hashtags#MSRA #MSRARevision #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #PuerperalPyrexia #PostpartumCare #SepsisAwareness #Obstetrics #MSRAObstetrics #UKMedEd #GPTraining