puerperal

Puerperal is an adjective relating to the puerperium, the period after childbirth during which the mother’s body returns to a nonpregnant state. In human obstetrics, the puerperium begins after delivery of the placenta and typically lasts about six weeks, during which the uterus involutes, lochia is expelled, and cervical and vaginal tissues heal.

Puerperal fever refers to postpartum infections that can occur during the puerperium. Historically a major cause of maternal mortality, puerperal fever is now primarily managed as a clinical syndrome resulting from bacterial infections acquired during or after delivery. Common pathogens include streptococci and anaerobic bacteria. Prevention has focused on hygiene, antisepsis, and timely antibiotic treatment when infection is suspected.

Historical context is notable for Ignaz Semmelweis, whose advocacy of handwashing by medical staff dramatically reduced mortality from puerperal fever in the 19th century. This work helped establish concepts of infection control and asepsis that underpin modern obstetric care.

Clinical aspects during the puerperium include monitoring for fever, uterine tenderness, excessive lochial discharge, uterine atony, and wound or perineal complications. Management emphasizes timely assessment for infection or other postpartum complications, appropriate antibiotic therapy when indicated, and support for uterine involution and maternal recovery. Risk factors for puerperal complications include cesarean delivery, prolonged or obstructed labor, manual removal of the placenta, preexisting infections, diabetes, and inadequate postnatal hygiene.

Etymology: from Latin puerpera, the woman who has just given birth, with -alis meaning pertaining to.