Fiebre Postparto

Descripción General

La fiebre postparto se define como:

• Una temperatura oral de ≥ 38℃ (≥ 100,4℉) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cualquiera de los LOS Neisseria 2 1ros días de los LOS Neisseria 10 días postparto, excluyendo las 1ras 24 horas
• Una temperatura oral de ≥ 38,7℃ (101,6℉) dentro de las 1ras 24 horas postparto

Las primeras 24 horas del postparto son diferentes porque la fiebre baja durante este período es común y suele resolverse espontáneamente, especialmente después de partos vaginales sin complicaciones.

Desde el punto de vista clínico, sería inadecuado esperar hasta que la fiebre esté presente durante > 24 horas antes de actuar; en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casi todos los LOS Neisseria casos, las pacientes deben ser evaluadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum persona con una evaluación diagnóstica adecuada y un tratamiento iniciado inmediatamente.

Epidemiología

• La fiebre postparto es una complicación que se produce en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 5–7% de las mujeres durante el postparto.
• La endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis (infección uterina) es la causa más común.
• La mayoría de los LOS Neisseria casos ocurren > 2 días después del nacimiento.
• Mayor incidencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria partos por cesárea que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria partos vaginales

Factores de riesgo

La mayoría de las etiologías comparten factores de riesgo comunes, que incluyen:

• Antecedentes de cesárea o de parto vaginal quirúrgico (e.g., extracción con ventosa)
• Cesárea de emergencia
• Ruptura prematura de membranas o ruptura prematura de membranas pretérmino
• Ruptura prolongada de membranas
• Trabajo de parto prolongado
• Exámenes vaginales múltiples o repetidos
• Retención de productos de la concepción
• Extracción manual de la placenta Placenta A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (chorionic villi) derived from trophoblasts and a maternal portion (decidua) derived from the uterine endometrium. The placenta produces an array of steroid, protein and peptide hormones (placental hormones). Placenta, Umbilical Cord, and Amniotic Cavity
• Infecciones recientes o no tratadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el momento del parto, por ejemplo:
  • Corioamnionitis
  • Bacteriuria Bacteriuria The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the urinary tract and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection. Urinary Tract Infections (UTIs) in Children
  • Vaginosis bacteriana
  • ETS (e.g., Chlamydia trachomatis Chlamydia trachomatis Type species of Chlamydia causing a variety of ocular and urogenital diseases. Chlamydia)
• Factores asociados a la mala cicatrización de las heridas:
  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus mal controlada
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types
  • Tabaquismo
  • Obesidad
  • Trastornos de inmunodeficiencia (e.g., VIH)
• Condiciones antihigiénicas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el nacimiento

Etiología y Fisiopatología

Etiología

Las etiologías más comunes de la fiebre postparto son:

• Endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis
• Infección del sitio quirúrgico o laceraciones perineales
• Mastitis Mastitis Mastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM). Mastitis/absceso mamario
• Infección del tracto urinario (ITU), especialmente pielonefritis
• Causas respiratorias:
  • Atelectasia
  • Neumonía por aspiración
  • Embolia pulmonar
• Causas trombóticas:
  • Tromboflebitis pélvica séptica
  • Trombosis venosa profunda
• Complicaciones de la anestesia neuraxial (poco frecuentes):
  • Meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis bacteriana o química
  • Absceso epidural
• Infección por Clostridium difficile Clostridium difficile A common inhabitant of the colon flora in human infants and sometimes in adults. The type species clostridioides difficile is formerly known as Clostridium difficile. It is a causative agent for clostridioides infections and is associated with pseudomembranous enterocolitis in patients receiving antibiotic therapy. Clostridia
• Fiebre por medicamentos (diagnóstico de exclusión)

Para recordar las principales causas de la fiebre posparto, piense en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las 7 W ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés):

• W – Wound (herida)*: infección de la herida quirúrgica o de la laceración perineal
• W – Womb (útero): endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis
• W – Woobies (mama): mastitis Mastitis Mastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM). Mastitis
• W – Water (agua)*: ITU
• W – Wind (viento)*: atelectasia, neumonía por aspiración, embolia pulmonar
• W – Walking (caminar)*: tromboflebitis pélvica séptica y/o trombosis venosa profunda (TVP)
• W – Wonder drugs (drogas maravillosas)*: fiebre por medicamentos

* También forman parte de la mnemotecnia de las 5 Ws WS Williams syndrome (WS), also known as Williams-beuren syndrome (WBS), is a genetic disease caused by a microdeletion on chromosome 7. Affected individuals have a characteristic elfin facies and short stature. Cognitive, developmental, and behavioral issues are common. Additionally, cardiovascular, connective tissue, endocrine, and renal anomalies may be present. Williams Syndrome para recordar las causas de la fiebre postoperatoria en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum todos las pacientes quirúrgicos.

Fisiopatología

La fisiopatología de la fiebre postparto depende de la etiología.

• Las infecciones, incluidas la endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis y las infecciones perineales/de heridas, suelen ser causadas por la flora cutánea y vaginal; por lo tanto, las infecciones:
  • Son polimicrobianas
  • Contienen bacterias aerobias como anaerobias
• La mastitis Mastitis Mastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM). Mastitis es causada por la flora oral del lactante, a menudo introducida a través de un traumatismo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el pezón producido durante la lactancia.
• Las ITU suelen producirse cuando la flora vaginal se introduce en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vejiga durante el sondaje frecuente o prolongado durante el trabajo de parto (más común con el uso de la anestesia epidural).
• Las infecciones postparto pueden convertirse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock si no se tratan a tiempo.
• Bacteriemia → lesión endotelial → inflamación, que puede dar lugar a:
  • Insuficiencia orgánica, incluidas las IRA y el síndrome de dificultad respiratoria aguda
  • Hipotensión y shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock séptico
  • Fallecimiento

Presentación Clínica

La presentación clínica de la fiebre postparto depende de la etiología subyacente, que determinará el momento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum que se desarrolle la fiebre y otros síntomas asociados.

Diagnóstico

La fiebre postparto es frecuentemente un diagnóstico clínico basado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la presentación y los LOS Neisseria factores de riesgo discutidos anteriormente, con laboratorios e imagenología utilizados para apoyar/confirmar el diagnóstico.

Antecedentes y examen físico

• Se hacen preguntas para obtener información sobre los LOS Neisseria factores de riesgo y los LOS Neisseria síntomas que puedan ayudar a descartar las etiologías mencionadas anteriormente.
• Evaluar y monitorizar los LOS Neisseria signos vitales del individuo (presión arterial, temperatura, frecuencia respiratoria y frecuencia cardíaca) para identificar inmediatamente si hay sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock o se desarrolla.
• Evaluar el útero:
  • Sensibilidad significativa: sugiere endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis
  • Anormalmente voluminoso: sugiere retención de productos de la concepción, que pueden estar infectándose
• Evaluar las heridas perineales y/o quirúrgicas.
• Comprobar si hay flujo vaginal anormal.
• Examinar las mamas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de signos de mastitis Mastitis Mastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM). Mastitis o abscesos.
• Examinar el tórax/pulmones y las piernas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de signos de infección y/o trombosis.

Laboratorios e imagenología

Con base en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hallazgos de los LOS Neisseria antecedentes y el examen, pueden ser apropiados los LOS Neisseria estudios de laboratorio y la imagenología para ayudar a apoyar el diagnóstico y guiar el tratamiento. Estos estudios incluyen:

• Hemograma:
  • El aumento de los LOS Neisseria leucocitos y la desviación a la izquierda sugieren una infección.
  • Nota: la leucocitosis general es común y normal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres postparto con recuentos promedio de leucocitos 10 000–16 000/µL.
• Análisis de orina
• Cultivos (con pruebas de sensibilidad a antibióticos):
  • Urocultivo
  • Cultivo de las heridas
  • Hemocultivo
• Si se sospecha de sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock: marcadores inflamatorios (e.g., lactato)
• Si se sospecha la retención de productos de la concepción:
  • Ultrasonido pélvico
  • Nota: el ultrasonido pélvico no suele estar indicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria casos de endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis rutinaria, ya que los LOS Neisseria hallazgos se solapan con los LOS Neisseria cambios normales del postparto.
• Si se sospecha trombosis:
  • Estudios de coagulación
  • Imagenología Doppler Doppler Ultrasonography applying the doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. Ultrasound (Sonography) con ultrasonido
• Si se sospecha una neumonía por aspiración: radiografía de tórax

Tratamiento y Prevención

El tratamiento de la fiebre postparto depende de la causa.

Medidas generales de soporte

• Descanso, nutrición e ingesta de líquidos adecuados
• Control del dolor Dolor Inflammation con analgésicos
• Monitorización regular Regular Insulin de los LOS Neisseria síntomas
• Prestar atención a los LOS Neisseria efectos del tratamiento sobre la lactancia materna:
  • Elegir antibióticos que sean seguros en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la lactancia.
  • La lactancia materna puede y debe continuarse con seguridad en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casi todos los LOS Neisseria casos.

Endometritis Endometritis Endometritis is an inflammation of the endometrium, the inner layer of the uterus. The most common subtype is postpartum endometritis, resulting from the ascension of normal vaginal flora to the previously aseptic uterus. Postpartum Endometritis

• Tratada con antibióticos intravenosos hasta que estén afebriles durante 24–48 horas
• Régimen intravenoso preferido: aminoglucósido (normalmente gentamicina) + clindamicina
• Régimen intravenoso alternativo: aminoglucósido + metronidazol
• Se debe añadir ampicilina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las pacientes colonizadas por Streptococcus Streptococcus Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci. Streptococcus del grupo B.

Infecciones de las heridas

• Drenaje, desbridamiento e irrigación
• Administración de antibióticos de amplio espectro (a menudo requiere cobertura para el Staphylococcus aureus Staphylococcus aureus Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. Brain Abscess resistente a la meticilina ( MRSA MRSA A strain of Staphylococcus aureus that is non-susceptible to the action of methicillin. The mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins. Staphylococcus, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
• Mantener limpias las heridas
• Limpieza vaginal con iodopovidona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos de heridas perineales infectadas
• Dieta rica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum fibra para disminuir el esfuerzo con los LOS Neisseria movimientos intestinales (el esfuerzo ejerce presión sobre las suturas quirúrgicas, causando dolor Dolor Inflammation y ↑ riesgo de dehiscencia)

Mastitis Mastitis Mastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM). Mastitis

• Utilice agentes antiestafilocócicos (p. ej., dicloxacilina, cefalexina) o clindamicina si existe alergia a los LOS Neisseria β-lactámicos o riesgo de MRSA MRSA A strain of Staphylococcus aureus that is non-susceptible to the action of methicillin. The mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins. Staphylococcus.
• Extracción frecuente y eficaz de la leche:
  • La estasis de leche ↑ infección, por lo que la leche debe seguir fluyendo.
  • Los LOS Neisseria organismos proceden de la flora oral del lactante, por lo que este no corre riesgo de infección → las pacientes deben continuar con la lactancia materna
• Compresas de hielo para aliviar la inflamación
• Los LOS Neisseria protectores de pezones pueden utilizarse durante la lactancia para evitar el agrietamiento el pezón.

Infección de las vías urinarias

• La cistitis simple (rara vez se presenta con fiebre) debe tratarse con antibióticos orales, normalmente con penicilinas.
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum general, se debe evitar lo siguiente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las madres lactantes con bebés < 1 mes de edad:
  • Nitrofurantoína (↑ riesgo de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lactante)
  • Trimetoprim-sulfametoxazol (↑ riesgo de kernicterus Kernicterus A term used pathologically to describe bilirubin staining of the basal ganglia; brain stem; and cerebellum and clinically to describe a syndrome associated with hyperbilirubinemia. Clinical features include athetosis, muscle spasticity or hypotonia, impaired vertical gaze, and deafness. Nonconjugated bilirubin enters the brain and acts as a neurotoxin, often in association with conditions that impair the blood-brain barrier (e.g., sepsis). This condition occurs primarily in neonates, but may rarely occur in adults. Hyperbilirubinemia of the Newborn)
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria casos de pielonefritis, suelen ser necesarios antibióticos intravenosos.

Flebitis pélvica séptica

• Administración de antibióticos de amplio espectro
• Ampicilina + gentamicina + clindamicina es un régimen común.
• Administración de anticoagulantes, a menudo heparina de bajo peso molecular (e.g., enoxaparina)

Prevención

La fiebre postparto suele ser una complicación prevenible. Las medidas preventivas que hay que tomar son:

• La técnica aséptica debe utilizarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum todos los LOS Neisseria procedimientos, si es posible, especialmente:
  • Sondaje vesical
  • Anestesia neuraxial
  • Cirugía (parto por cesárea)
• Uso adecuado de antibióticos profilácticos, por ejemplo:
  • Antes del parto por cesárea (normalmente cefazolina +/- azitromicina)
  • Tras la extracción manual de la placenta Placenta A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (chorionic villi) derived from trophoblasts and a maternal portion (decidua) derived from the uterine endometrium. The placenta produces an array of steroid, protein and peptide hormones (placental hormones). Placenta, Umbilical Cord, and Amniotic Cavity
• Limpieza vaginal con una solución de iodopovidona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el quirófano antes de la cesárea en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con rotura de membranas
• Mantener las incisiones limpias.
• Limpiar la zona vaginal con agua después de ir al AL Amyloidosis baño.
• Lactancia materna y/o extracción de leche regular Regular Insulin para evitar la estasis de leche
• Uso de un protector de pezones para evitar grietas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria mismos

Complicaciones y Pronóstico

Complicaciones

• Sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock
• Formación de abscesos
• Adherencias/formación de tejido cicatrizal (que puede provocar futuros dolores y/o problemas de fertilidad)
• Embolia pulmonar
• CID

Pronóstico

• La intervención temprana da lugar a una recuperación completa sin complicaciones para la gran mayoría de las pacientes.
• Las pacientes deben ser monitorizadas cuidadosamente y debe administrarse un tratamiento agresivo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria casos de progresión a sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock.
• La fiebre postparto no tratada o la intervención tardía aumentan las posibilidades de complicaciones graves.