
Puerperal fever is a condition characterized by a fever lasting more than 24 hours within the first ten days after childbirth, usually due to an infection, often at the site where the placenta was attached. If this infection spreads to the bloodstream, it becomes a serious condition known as puerperal sepsis. Historically, puerperal fever has been referred to by various names, including childbirth fever. The term "puerperal" is derived from Latin, where "puerpera" describes a woman in the process of childbirth, with "puer" meaning child and "parere" meaning to give birth. This period immediately follows the delivery of a baby.Historically, several figures are prominently associated with the study and understanding of puerperal fever: Alexander Gordon, Oliver Wendell Holmes, and Ignaz Philipp Semmelweis. Dr. Alexander Gordon (1752-1799) from Aberdeen, Scotland, was the first to identify the cause of puerperal fever. In 1795, he observed that puerperal fever and erysipelas occurred simultaneously and suggested they might be related epidemics. He noted that after childbirth, the infectious material could easily enter the body through the numerous open orifices left by the placenta's separation from the uterus. He admitted that he had unintentionally spread the infection to many women by visiting or delivering them after attending infected patients.In 1843, Oliver Wendell Holmes (1809?-1894), a Harvard professor, emphasized the contagious nature of puerperal fever in his paper "On the Contagiousness of Puerperal Fever." He warned that if a physician had one case of puerperal fever, the risk of another increased; two cases suggested the physician should stop practicing for at least a month, and three cases strongly indicated the physician was the source of the infection.Ignaz Philipp Semmelweis (1818-1862), a Viennese physician, provided conclusive evidence of the cause of puerperal fever. In 1847, he instituted a practice of hand washing with chlorinated water before childbirth, which significantly reduced the mortality rate from childbed fever. Semmelweis acknowledged the tragic consequences of not recognizing the cause sooner, admitting, "Puerperal fever is caused by the conveyance of putrid particles from living organisms to the pregnant woman, through the examining fingers... I must confess that only God knows how many women I have prematurely consigned to the grave."
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