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This term applies to diseases occurring in a woman within the first six weeks of her delivery.
Infections are most common of the puerperal disorders. They could affect the uterus (womb), breast, urinary bladder, lungs or the delivery wound. Breast problems include engorgement, localized collections of pus and cracked or sore nipples. Other puerperal disorders include bleeding and a variety of psychiatric problems.
Most infections present with fever and localizing signs. The cause of fever needs to be found out and treatment instituted. Breast pain could be due to infection, engorgement of milk due to inability to express or a localized collection of pus. Bleeding could be due to several factors and of varying amounts. Some mood changes are noticed in many women in the first week after a delivery. A close watch is essential to detect worsening.
Plenty of oral fluids in the post delivery period are helpful in avoiding urinary infections. Breast-feeding should be monitored in the first few days to ensure correct methods are being used. Breasts need to be emptied after every feed. Nipples need to be cared for from the last three months of pregnancy.
After identifying the cause of infection, appropriate treatment needs to be instituted. Hospitalization and the intravenous route for antibiotics may be needed in severe cases of sepsis. Otherwise outpatient treatment may suffice. Caution needs to be governed keeping in mind that most antibiotics are excreted in breast milk. Breast engorgement needs decompressing by a breast pump while localized pus collections need to be drained. Psychiatric problems need supportive treatment failing which medicines need to be started.
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