Endometritis

Source: Wikipedia, the free encyclopedia.
Not to be confused with Endometriosis.
Endometritis
Other namesPostpartum endometritis, endomyometritis
Antibiotics[1]
PrognosisGood with treatment[4]
Frequency2% (following vaginal delivery),
10% (following scheduled C-section)[5]

Endometritis is inflammation of the inner lining of the uterus (endometrium).[6] Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge.[1][4] It is the most common cause of infection after childbirth.[7][1] It is also part of spectrum of diseases that make up pelvic inflammatory disease.[8]

Endometritis is divided into acute and chronic forms.

prolonged rupture of membranes.[1] Chronic endometritis is more common after menopause.[2] The diagnosis may be confirmed by endometrial biopsy.[3] Ultrasound may be useful to verify that there is no retained tissue within the uterus.[4]

Treatment is usually with antibiotics.[1] Recommendations for treatment of endometritis following delivery includes clindamycin with gentamicin.[9] Testing for and treating gonorrhea and chlamydia in those at risk is also recommended.[10] Chronic disease may be treated with doxycycline.[10] Outcomes with treatment are generally good.[4]

Rates of endometritis are about 2% following

cows.[12]

Symptoms

Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge.[1][4]

Types

Acute endometritis

Acute endometritis is characterized by infection. The organisms most often isolated are believed to be because of compromised abortions, delivery, medical instrumentation, and retention of placental fragments.

IV antibiotic treatment
.

In certain populations, it has been associated with Mycoplasma genitalium and pelvic inflammatory disease.[15][16]

Chronic endometritis

Chronic endometritis is characterized by the presence of

Group B Streptococcus), Mycoplasma hominis, tuberculosis, and various viruses. Most of these agents are capable of causing chronic pelvic inflammatory disease (PID). Patients with chronic endometritis may have an underlying cancer of the cervix or endometrium (although infectious cause is more common). Antibiotic therapy is curative in most cases (depending on underlying cause), with fairly rapid alleviation of symptoms after only 2 to 3 days. Women with chronic endometritis are also at a higher risk of pregnancy loss and treatment for this improves future pregnancy outcomes.[17][18]

Chronic granulomatous endometritis is usually caused by tuberculous. The granulomas are small, sparse, and without caseation. The granulomas take up to 2 weeks to develop and since the endometrium is shed every 4 weeks, the granulomas are poorly formed.

In human medicine, pyometra (also a veterinary condition of significance) is regarded as a form of chronic endometritis seen in elderly women causing stenosis of the cervical os and accumulation of discharges and infection. Symptom in chronic endometritis is blood stained discharge but in pyometra the patient complaints of lower abdominal pain.

Pyometra

Main article: Pyometra

Pyometra describes an accumulation of pus in the uterine cavity.[19] In order for pyometra to develop, there must be both an infection and blockage of cervix. Signs and symptoms include lower abdominal pain (suprapubic), rigors, fever, and the discharge of pus on introduction of a sound into the uterus. Pyometra is treated with antibiotics, according to culture and sensitivity.[20]

See also

References

  1. ^
    ISBN 9781455775583
    .
  2. ^
    ISBN 9783642015410
    .
  3. ^
    ISBN 9780323430036
    .
  4. ^
    ISBN 9780323084307
    .
  5. ^
    ISBN 978-1437719352
    .
  6. ISBN 978-1455708956
    .
  7. ISBN 9789350904244
    .
  8. ISBN 978-0071638562
    .
  9. PMID 25922861
    .
  10. ^
    ISBN 9780071849081
    .
  11. ISBN 978-0-7817-5532-0
    .
  12. ISBN 9780702039904
    .
  13. ^ "Endometritis - Pregnancy Articles". pregmed.org. 21 November 2013. Retrieved 11 April 2018.
  14. PMID 25327508
    .
  15. S2CID 36191700
    .
  16. PMID 25614838
    .
  17. PMID 33025403
    .
  18. S2CID 227283325
    .
  19. ^ "Pyometra". American College of Veterinary Surgeons. 2004. Archived from the original on 2006-02-21. Retrieved 2006-12-14.
  20. PMID 27855712
    .

External links

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