Postpartum Infections Workup

Updated: Jan 03, 2017
  • Author: Andy W Wong, MD; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Workup

Laboratory Studies

Laboratory studies are directed at elucidating the severity of illness as well as the etiology of the infection. Mild cases of mastitis usually do not require laboratory investigation. Wound infections and infections of the genital tract makes it more difficult to ascertain the extent of involvement.

Laboratory studies should include the following:

  • Complete blood count
  • Electrolytes
  • Blood cultures, if sepsis is suspected
  • Urinalysis, with cultures and sensitivity tests
  • Cervical or uterine cultures
  • Wound cultures, if appropriate
  • Lactate, if sepsis suspected
  • Coagulation studies, if pelvic thrombosis, deep vein thrombosis, pulmonary embolism, or invasive treatment (eg, surgical procedure) is being considered
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Imaging Studies

Pelvic ultrasonography may be helpful in detecting retained products of conception, pelvic abscess, or infected hematoma.

Contrast-enhanced CT or MRI are useful in establishing the diagnosis of septic pelvic thrombosis. [12]

In some cases, a contrast-enhanced CT examination of the abdomen and pelvis may be helpful if concurrent concern is present for other non-pregnancy–related abdominal/pelvic sources of the infection (eg, appendicitis, colitis).

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