Persistent postpartum fever:
Refers to a lack of improvement or deterioration in clinical status after 48 hours of treatment.
Re-evaluate the patient, perform a full physical exam and consider imaging like Ultrasound to exclude retained products of conception (RPOC), Consultation to Infectious disease team (ID team).
Consider other causes like Infected hematoma, Pelvic abscess, Pelvic cellulitis, Wound infection, Septic pelvic thrombophlebitis, ovarian vein thrombosis.
Treatment: consider antibiotics changes (consult ID team); consider gentle curettage if there is RPOC to remove necrotic tissue. “Gentle” to prevent uterine scarring/ Asherman’s syndrome.