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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.

Causes

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)
  • Childbirth (more common after C-section than vaginal birth)

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, Birsner M. Maternal and perinatal infection in pregnancy: bacterial. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 54.

Gardella C, Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Smaill FM, Grivell RM. 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, Bolan GA; 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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  • Pelvic laparoscopy

    Pelvic laparoscopy - illustration

    Laparoscopy is performed when less-invasive surgery is desired. It is also called Band-Aid surgery because only small incisions need to be made to accommodate the small surgical instruments that are used to view the abdominal contents and perform the surgery.

    Pelvic laparoscopy

    illustration

  • Endometritis

    Endometritis - illustration

    Endometritis is the inflammation and/or irritation of the endometrium. It is usually caused by an infection.

    Endometritis

    illustration

    • Pelvic laparoscopy

      Pelvic laparoscopy - illustration

      Laparoscopy is performed when less-invasive surgery is desired. It is also called Band-Aid surgery because only small incisions need to be made to accommodate the small surgical instruments that are used to view the abdominal contents and perform the surgery.

      Pelvic laparoscopy

      illustration

    • Endometritis

      Endometritis - illustration

      Endometritis is the inflammation and/or irritation of the endometrium. It is usually caused by an infection.

      Endometritis

      illustration

    Self Care

     

      Tests for Endometritis

       
         

        Review Date: 8/26/2017

        Reviewed By: Peter J. Chen, MD, FACOG, Associate Professor of OBGYN at Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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