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Endometritis

 

Endometritis is an inflammation or irritation of the lining of the uterus (the endometrium). It is not the same as endometriosis.

Endometritis is caused by an infection in the uterus. It can be due to chlamydia, gonorrhea, tuberculosis, or a mix of normal vaginal bacteria. It is more likely to occur after miscarriage or childbirth. It is also more common after a long labor or C-section.

The risk of endometritis is higher after having a pelvic procedure that is done through the cervix. Such procedures include:

  • D and C (dilation and curettage)
  • Endometrial biopsy
  • Hysteroscopy
  • Placement of an intrauterine device (IUD)

Endometritis can occur at the same time as other pelvic infections.

Symptoms

 

Symptoms may include:

  • Swelling of the abdomen
  • Abnormal vaginal bleeding or discharge
  • Discomfort with bowel movement (including constipation)
  • Fever
  • General discomfort, uneasiness, or ill feeling
  • Pain in lower abdomen or pelvic region (uterine pain)

 

Exams and Tests

 

The health care provider will perform a physical exam with a pelvic exam. Your uterus and cervix may be tender and the provider may not hear bowel sounds. You may have cervical discharge.

The following tests may be performed:

  • Cultures from the cervix for chlamydia, gonorrhea, and other organisms
  • Endometrial biopsy
  • ESR (erythrocyte sedimentation rate)
  • Laparoscopy
  • WBC (white blood count)
  • Wet prep (microscopic exam of any discharge)

 

Treatment

 

You will need to take antibiotics to treat the infection and prevent complications. Finish all your medicine if you have been given antibiotics after a pelvic procedure. Also, go to all follow-up visits with your provider.

You may need to be treated in the hospital if your symptoms are severe or occur after childbirth.

Other treatments may involve:

  • Fluids through a vein (by IV)
  • Rest

Sexual partners may need to be treated if the condition is caused by a sexually transmitted infection (STI).

 

Outlook (Prognosis)

 

In most cases, the condition goes away with antibiotics. Untreated endometritis can lead to more serious infections and complications.

 

Possible Complications

 

Complications may include:

  • Infertility
  • Pelvic peritonitis (generalized pelvic infection)
  • Pelvic or uterine abscess formation
  • Septicemia
  • Septic shock

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of endometritis.

Call right away if symptoms occur after:

  • Childbirth
  • Miscarriage
  • Abortion
  • IUD placement
  • Surgery involving the uterus

 

Prevention

 

Endometritis is caused by STIs. To help prevent endometritis from STIs:

  • Treat STIs early.
  • Make sure sexual partners are treated in the case of a STI.
  • Follow safer sex practices, such as using condoms.

Women having a C-section may have antibiotics before the procedure to prevent infections.

 

 

References

Duff P. Maternal and perinatal infection -- bacterial. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 51.

Eckert LO, Lentz GM. Infections of the lower and upper genital tract. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23.

Smaill FM, Gyte GM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev. 2014;10:CD007482. PMID: 25350672 www.ncbi.nlm.nih.gov/pubmed/25350672.

Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137. PMID: 26042815 www.ncbi.nlm.nih.gov/pubmed/26042815.

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        Review Date: 9/26/2015

        Reviewed By: Daniel N. Sacks, MD, FACOG, pbstetrics & gynecology in private practice, West Palm Beach, FL. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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