<prompt> Common route of spread of puerperal sepsisLymphaticDirect invasionSkip lesionHematogenous  <response>: Puerperal pyrexia is defined as a rise of temperature reaching 100.4 F 38 C or more measured orally on 2 separate occasions at 24 hours apart excluding first 24 hours within first 10 days following delivery.Any infection of genital tract which occurs as a complication of delivery is called as Puerperal sepsis.Most common site of Puerperal infection Placental site. In vaginal delivery and uterine incision in cesarean section.Most common manifestation of Puerperal infection Endometritis.Most common cause of Puerperal sepsis Streptococcus.Most common route of infection Direct spread.Single most significant risk factor for development of puerperal sepsis uterine infection Route of delivery It is MC in cesarean delivery than vaginal deliveryMgt: Clindamycin Gentamycin Ampicillin 