Managing Complications in Pregnancy and Childbirth: - IAWG

S-116 Fever after childbirthBREAST ABSCESS• Treat with antibiotics (page C-35):- cloxacillin 500 mg by mouth four times per day for 10 days;- OR erythromycin 250 mg by mouth three times per day for 10days.• Drain the abscess:- General anaesthesia (e.g. ketamine, page P-13) is usuallyrequired;- Make the incision radially extending from near the alveolarmargin towards the periphery of the breast to avoid injury tothe milk ducts;- Wearing high-level disinfected gloves, use a finger or tissueforceps to break up the pockets of pus;- Loosely pack the cavity with gauze;- Remove the gauze pack after 24 hours and replace with asmaller gauze pack.• If there is still pus in the cavity, place a small gauze pack in thecavity and bring the edge out through the wound as a wick tofacilitate drainage of any remaining pus.• Encourage the woman to:- continue breastfeeding even when there is collection of pus;- support breasts with a binder or brassiere;- apply cold compresses to the breasts between feedings toreduce swelling and pain.• Give paracetamol 500 mg by mouth as needed.• Follow up 3 days after initiating management to ensure response.INFECTION OF PERINEAL AND ABDOMINAL WOUNDSWOUND ABSCESS, WOUND SEROMA AND WOUND HAEMATOMA• If there is pus or fluid, open and drain the wound.