[35F] Postpartum patient with severe abdominal pain and potential ileus

Patient Description

A 35-year-old female presents with severe lower abdominal pain described as sharp and cramping, rated 10/10 in severity, following a vaginal delivery after a cesarean section. The patient also reports a fever, ileus, and an increased white blood cell count. These symptoms have been present since the delivery. There is no history of injury or accident that could have contributed to the pain, and the patient is not currently pregnant. The pain does not radiate to other areas.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing one of the following conditions:

  • Postpartum Infection: This is an infection that occurs after childbirth. The symptoms can include fever, abdominal pain, and an increased white blood cell count. The infection can occur at different sites, such as the uterus (endometritis), the wound from a cesarean section, or an episiotomy.

    • Treatment typically involves antibiotics to fight the infection.
  • Postoperative Ileus: This is a temporary delay in the normal movement of the intestines, which can occur after abdominal surgery. Symptoms can include abdominal pain and swelling, nausea, and vomiting.

    • Treatment usually involves supportive care, such as intravenous fluids and pain relief, until normal bowel function returns.

What you can do

Given the severity of your symptoms, it is crucial that you seek immediate medical attention. Here's what you can do:

  1. Contact your healthcare provider immediately or go to the nearest emergency department.
  2. Describe your symptoms accurately to the healthcare provider, including the onset, duration, and any changes in your symptoms.
  3. Follow the treatment plan prescribed by your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe or worsening pain
  • High fever
  • Foul-smelling vaginal discharge
  • Heavy vaginal bleeding
  • Difficulty breathing

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of a postpartum infection?

Common symptoms of a postpartum infection include fever, lower abdominal pain, increased white blood cell count, foul-smelling vaginal discharge, and sometimes heavy bleeding. It is important to seek medical attention if these symptoms occur.


How is postoperative ileus diagnosed and treated?

Postoperative ileus is diagnosed based on symptoms such as abdominal pain, swelling, nausea, and vomiting, often following abdominal surgery. Treatment typically involves supportive care, including intravenous fluids, pain management, and sometimes nasogastric decompression, until bowel function returns to normal.


What are the risks of having a fever after childbirth?

A fever after childbirth can indicate an infection, such as endometritis or a wound infection. It is important to monitor for other symptoms like severe pain, foul-smelling discharge, or heavy bleeding, and seek medical attention promptly to prevent complications.


When should I seek medical attention for postpartum abdominal pain?

You should seek medical attention for postpartum abdominal pain if it is severe, worsening, or accompanied by other symptoms like high fever, foul-smelling discharge, or heavy bleeding. Prompt evaluation by a healthcare provider is essential to determine the cause and appropriate treatment.


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