O91.213 Nonpurulent mastitis associated with pregnancy, third trimester

Name of the Condition

• Nonpurulent Mastitis Associated with Pregnancy, Third Trimester (O91.213)

Summary

This condition involves inflammation of the breast tissue during the third trimester of pregnancy without pus formation. It may present with localized pain, swelling, or redness and requires evaluation to distinguish from infectious causes. Management focuses on symptom relief and monitoring for progression.

Causes

Nonpurulent mastitis in the third trimester is often linked to hormonal changes, milk duct engorgement, or mechanical irritation. Unlike purulent forms, it typically lacks bacterial infection, though inflammation may still occur due to milk stasis or tissue trauma.

Risk Factors

• Hormonal fluctuations in the third trimester.
• Engorgement or blocked milk ducts.
• Previous breast inflammation.
• Mechanical irritation from clothing or activity.

Symptoms

• Breast pain, tenderness, or swelling.
• Redness or warmth in the affected area.
• Mild systemic symptoms (e.g., low-grade fever).
• Absence of pus or significant discharge.

Diagnosis

Diagnosis is clinical, based on physical examination and symptom assessment. Cultures are generally not required unless infection is suspected. Imaging (e.g., ultrasound) may be used to rule out abscess or other complications.

Treatment Options

• Warm compresses to relieve discomfort.
• Gentle breast massage to improve milk flow.
• Supportive care for symptom management.
• Monitoring for signs of infection or progression.

Prognosis and Follow-Up

Most cases resolve with conservative management. Follow-up ensures symptoms improve and no complications develop. Persistent or worsening symptoms may require further evaluation.

Complications

• Progression to purulent mastitis or abscess.
• Severe pain or discomfort affecting daily activities.
• Rarely, systemic infection if untreated.

Lifestyle & Prevention

• Wear well-fitting, supportive bras.
• Avoid excessive pressure on the breasts.
• Maintain good breast hygiene.
• Address engorgement promptly to reduce inflammation risk.

When to Seek Professional Help

Seek care if symptoms worsen, fever develops, or pus is present. Persistent pain or redness beyond a few days also warrants evaluation.

Tips for Medical Coders

Document the trimester (third trimester) and confirm nonpurulent inflammation. Ensure clinical notes support the absence of pus or infection to justify this specific code.