Postpartum endometritis, also known as puerperal fever, is caused by infection of
the womb (uterus) during childbirth. It occurs in about 1% to 3% of births, and is
up to ten times more common after caesarean section. The diagnosis of endometritis
should be considered when a postpartum woman has febrile morbidity
(oral temperature ≥38.0°C on two occasions between day 1-10 after birth) abdominal
pain or foul smelling lochia.
The combination of gentamicin and clindamycin is effective for the treatment
of endometritis but is very expensive.
There is a need for more studies in low-income countries to evaluate optimal
antibiotic regimens and the cost-effectiveness of different antibiotic regimens.