ODOBGYNDECODED

← All presentations

Fever in pregnancy/postpartum

Bleeding in pregnancyAbdominal pain in pregnancyReduced fetal movementsHeadache + high BP in pregnancy/postpartumFever in pregnancy/postpartumDyspnoea in pregnancyVaginal discharge / cervicitisAcute pelvic pain (non-pregnant)Postmenopausal bleedingInfertility evaluation
Immediate red flags:
  • Rigors+hypotension (sepsis)
  • Retained products + uterine tenderness
  • Wound necrosis/pain out of proportion
  • Respiratory distress
Urgent workup:
  • Sepsis screening bundle
  • Cultures BEFORE antibiotics
  • US for RPOC/collections

Structured differential — act in priority order

PriorityConditionKey featuresAction
CANNOT MISS
Endometritis/septic abortion
Uterine tenderness+foul discharge
Sepsis module + evacuation →
CANNOT MISS
Chorioamnionitis
Intrapartum fever+foul liquor
Antibiotics+birth →
COMMON
Mastitis/breast abscess
Localised breast signs
Continue feeding + antibiotics; US if fluctuant
COMMON
Pyelonephritis
Loin pain+urine pyuria
UTI module →
CONSIDER
Influenza/COVID/malaria (region)
Epidemiology+respiratory/parasite tests
Respective protocols
CONSIDER
Thrombophlebitis/PE
Leg signs/chest symptoms
VTE module →

First moves

  1. Antibiotics within the hour for true sepsis physiology