title: Diagnosis of postpartum infections: clinical criteria are better than laboratory parameter.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, DCH Regional Medical Center, Tuscaloosa, Alabama, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Partlow
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: Linda
authors.initials: L
authors.lastname: Justice
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Rick W
authors.initials: RW
authors.lastname: Martin
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: 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