An infection, once called puerperal fever which starts in the genital tract within ten days after childbirth, miscarriage or abortion (see PREGNANCY AND LABOUR). Once a scourge of childbirth, with many women dying from the infection, there has been a dramatic decline in its incidence in developed countries, with only 1–3 per cent of women having babies now being affected. This decline is due to much better maternity care and the advent of ANTIBIOTICS. Infection usually starts in the VAGINA and is caused by the bacteria that normally live in it: they can cause harm because of the mother's lowered resistance, or when part of the PLACENTA has been retained in the genital tract. The infection usually spreads to the UTERUS and sometimes to the FALLOPIAN TUBES. Sometimes bacteria may enter the vagina from other parts of the body.

Fever, an offensive-smelling post-partum vaginal discharge (lochia) and pain in the lower abdomen are the main features. Untreated, the women may develop SALPINGITIS, PERITONITIS and septicaemia. Antibiotics are used to treat the infection and any retained placental tissue must be removed.