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Endometritis

 

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Endometritis

Definition

Endometritis is an inflammation or irritation of the lining of the uterus (the endometrium).

See also: Pelvic inflammatory disease

Causes

Endometritis is caused by infections such as chlamydia, gonorrhea, tuberculosis, or mixtures of normal vaginal bacteria. Endometritis is more likely to occur after childbirth, miscarriage, or placement of an intrauterine device (IUD).

Any surgical procedure that enters the uterus through the cervix will increase the risk of developing endometritis. Endometritis can occur at the same time as other pelvic infections such as acute salpingitis, acute cervicitis, and many sexually transmitted diseases (STDs).

Symptoms

• Abdominal distention
• Abnormal vaginal bleeding
• Abnormal vaginal discharge
  • Increased amount
  • Unusual color, consistency, or odor
• Discomfort with bowel movement (constipation may occur)
• Fever (ranging from 100 to 104 degrees Fahrenheit)
• General discomfort, uneasiness, or ill feeling (malaise)
• Lower abdominal or pelvic pain (uterine pain)

Exams and Tests

The health care provider will perform a physical exam and a pelvic exam. The lower abdomen may be tender. Bowel sounds may be decreased. A pelvic exam may cause the uterus and cervix to feel tender. There may be cervical discharge.

The following tests may be performed:

• Cultures from the cervix for chlamydia, gonorrhea, and other organisms
• Endometrial biopsy
• ESR (sedimentation rate)
• Laparoscopy
• WBC (white blood count)

Treatment

Treatment with antibiotics is important to prevent complications of endometritis.

Complicated cases (those occurring after childbirth, or involving severe symptoms) may require the patient to be admitted to a hospital. Intravenous (in the vein) antibiotics are usually needed, followed by antibiotics taken by mouth.

Rest and hydration are important.

Treatment for sexual partner(s), when appropriate, and the use of condoms throughout the course of treatment, are essential.

Outlook (Prognosis)

Most cases of endometritis go away with antibiotics. Untreated endometritis can lead to more serious infection and complications with pelvic organs, reproduction, and general health.

Possible Complications

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

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of endometritis.

Call immediately if you recently had a baby, had an abortion, had an IUD placed, or had any surgery involving the uterus.

Prevention

Endometritis caused by sexually transmitted infections can be prevented by:

• Early diagnosis and complete treatment of sexually transmitted diseases in yourself and all sexual partners
• "Safer" sexual practices

The risk of endometritis is reduced by the careful, sterile techniques used by appropriate providers in performing deliveries, abortions, IUD insertions, and other gynecological procedures.

If you've been prescribed antibiotics following a procedure, it is very important to finish all the medication and follow up with your health care provider.

References

Duff P. Maternal and Perinatal Infection -- Bacterial. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Gabbe: Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2007: chap 49.

Eckert LO, Lentz, GM. Infections of the Upper Genital Tract. In: Katz Vl, Lentz GM, Lobo RA, Gershenson DM, eds. Katz: Comprehensive Gynecology. 5th ed. Philadelphia, PA: Mosby Elsevier; 2007: chap 23.

Faro S. Postpartum endometritis. Clin Perinatol. 2005; 32(3): 803-14.

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