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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
  • Endometrial biopsy
  • Hysteroscopy
  • Placement of an intrauterine device (IUD)

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

Symptoms


  • 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:

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 health care 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.

Outlook (Prognosis)

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

Possible Complications


When to Contact a Medical Professional

Call your health care 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 caused by sexually transmitted infections can be prevented by:

  • Treating sexually transmitted infections early
  • Making sure sexual partners are treated in the case of a sexually transmitted infection
  • Following 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: Saunders Elsevier; 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: Mosby Elsevier; 2012:chap 23.

Smaill FM, Gyte GM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007482.

Updated: 8/5/2013

Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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