Prise en charge des infections du post-partum

Lamy, Claire; Zuily, Stéphane; Perdriolle, E.; Gauchotte, Émilie; S, Villeroy-de-Galhau; Mo, Delaporte; Wahl, Denis; Morel, Olivier; Judlin, P

doi:10.1016/j.jgyn.2012.09.024

Cited by 12 publications

(2 citation statements)

References 70 publications

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“…Its most common complications are the extension of thrombosis to the renal veins, iliofemoral vein and inferior vena cava, all of which were described in this case report (8) . There is also a 13% risk of evolution with pulmonary embolism and sepsis with septic emboli that can be fatal in 5% of complicated cases.…”

Section: Discussionmentioning

confidence: 59%

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Extensive septic pelvic thrombophlebitis in a puerperal woman: a case report

Armstrong¹,

Barili²,

Monteiro³

et al. 2023

ISJHR

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OBJECTIVE: This article aims to report an extensive case of septic pelvic thrombophlebitis, a rare, severe, and challenging diagnostic condition. The clinical picture may range from mild to severe sepsis. Its diagnosis is of exclusion, but it can be complemented with imaging exams. CASE DESCRIPTION: We report a case of postpartum thrombophlebitis in the infrarenal portion of the inferior vena cava, external and internal common iliac veins, bilateral common femoral veins, as well as in the right ovarian vein, presenting with persistent fever and negative cultures. The patient showed significant clinical improvement after association of anticoagulation and antibiotic therapy. CONCLUSION: Septic pelvic thrombophlebitis is an important differential diagnosis for abdominal pain and fever in the postpartum period, but the absence of specific complementary tests makes its diagnosis challenging, which often leads to misdiagnosis of acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, adnexal torsion, or pelvic abscess. The key to correct diagnosis is a high level of clinical suspicion, especially when there is resistance to broad-spectrum antibiotic therapy and remission after systemic anticoagulation. Given the large number of cesarean sections performed today and their correlation with septic pelvic thrombophlebitis, an increase in the number of cases should be accompanied by greater familiarity of health professionals with this complication, in order to avoid inadequate propaedeutics and conducts. In this context, the present case report documents the importance of investigating pelvic septic thrombosis in patients with fever in the puerperium and its differential diagnoses for early initiation of therapy to reduce morbidity and mortality.

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Section: Discussionmentioning

confidence: 59%

“…There is also a 13% risk of evolution with pulmonary embolism and sepsis with septic emboli that can be fatal in 5% of complicated cases. (4,8) .…”

Section: Discussionmentioning

confidence: 99%

Extensive septic pelvic thrombophlebitis in a puerperal woman: a case report

Armstrong¹,

Barili²,

Monteiro³

et al. 2023

ISJHR

View full text Add to dashboard Cite

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Les endométrites obstétricales au CHU-Yalgado Ouédraogo de Ouagadougou (Burkina Faso). À propos de la prise en charge d’une série de 102 cas

Ouédraogo

Ouattara

Abourazzak

et al. 2016

Bull. Soc. Pathol. Exot.

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This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.

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