Diagnosis of postpartum infections: clinical criteria are better than laboratory parameter.
BACKGROUND
Physiologic increases in the leukocyte count and segmental neutrophil percentage during pregnancy alter the ability of these indices to predict infection.


METHODS
Women with cesarean deliveries were assessed by leukocyte counts and segmented neutrophil percentage as well as clinical signs to detect postoperative infection.


RESULTS
In 157 consecutive patients undergoing cesarean deliveries there was a significant physiologic increase between the preoperative and postoperative leukocyte count (12.4 +/- 3.9/uL vs. 14.8 +/- 3.4/uL, P < 0.001). The leukocyte count after delivery did not discriminate whether or not the patient would develop a postpartum infection or have significant hyperpyrexia.


CONCLUSIONS
Due to physiologic changes associated with pregnancy, the leukocyte count and segmented neutrophil percentage do not predict infection. Therefore clinical findings are most important in diagnosing postpartum infections.
Partlow
David B
DB
Department of Obstetrics and Gynecology, DCH Regional Medical Center, Tuscaloosa, Alabama, USA.
Chauhan
Suneet P
SP
Justice
Linda
L
Magann
Everett F
EF
Martin
Rick W
RW
Morrison
John C
JC
D000328:Adult; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D004716:Endometritis / Q000175:diagnosis; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D009504:Neutrophils; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D049590:Postpartum Period / Q000097:blood; D011237:Predictive Value of Tests; D011247:Pregnancy; D011645:Puerperal Infection / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D014946:Wound Infection / Q000175:diagnosis