Endometritis - an infection that causes inflammation of the surface layer of the endometrium. It can be acute or chronic. Typically, an infection that leads to endometritis, begins in the vagina, the endometrium and then strikes and then may spread to the fallopian tubes and ovaries, causing an inflammatory disease such as adnexitis. Specialists is no consensus on whether endometritis independent disease, or it should be attributed to pelvic inflammatory disease.

After a natural, uncomplicated childbirth risk of endometritis is 1-3%. After cesarean section, depending on other risk factors, the probability of disease endometritis may increase to 19-40%. For prevention may be used antibiotics such as doxycycline and azithromycin.

Causes of acute endometritis

Postpartum endometritis is usually caused by infection, pathogens which entered the reproductive system during or after delivery or caesarean section. The causes of acute endometritis can also be pelvic inflammatory disease, and gynecological procedures.

Causes of chronic endometritis

Chlamydia and gonorrhea are becoming agents of chronic endometritis is quite rare compared with other bacteria such as mycoplasma. After childbirth or surgical abortion chronic endometritis may develop if left in the uterus of the products of conception Conception - as the emerging life And this has led to the growth of bacteria. Sometimes the causes of chronic endometritis are tuberculosis and bacterial vaginosis. This disease may also develop after you install an intrauterine device IUD: a reliable and efficient means .

Risk factors

Factors that increase the risk of endometritis after delivery:

• Caesarean section (especially in HIV-infected women);
• Prolonged labor;
• Manualnomu removal of the placenta;
• Deliveries at the age of 40 years;
• Low socioeconomic status and other factors, which may birth at home, and non-compliance with health standards;
• Anemia in women during pregnancy.
• Risk factors for non-pregnant women:
• The use of intrauterine devices;
• Douching;
• Stagnation of menses;
• Unprotected sex;
• We have multiple sexual partners the patient.

Symptoms

Endometriosis can cause the following symptoms:

• Fever;
• Abdominal pain;
• Abnormal vaginal bleeding, including severe postpartum hemorrhage;
• Abnormal vaginal discharge;
• Dyspareunia - pain in the abdomen and in the area of ​​the external genitalia;
• Dysuria;
• Malaise;
• Tachycardia.

Diagnostics

To diagnose endometriosis usually do a blood smear analysis and urinalysis. Based on the test results can be the cause of the disease. Ultrasonography for the diagnosis of this disorder is not applicable.

In the differential diagnosis should exclude diseases such as appendicitis, pelvic inflammatory disease, pyelonephritis, urinary tract infection.

Treatment

In acute endometritis appointed intravenous solution of clindamycin or gentamicin. Treatment continues until until it is stable improvement continued at least for 24 hours. Use of oral antibiotics after such treatment is not usually required.

For the treatment of chronic endometritis can be used amoxicillin, gentamicin or metronidazole Metronidazole: guard inflammation   for oral administration, or a combination of these types of antibiotics. If endometriosis is caused by chlamydia, appointed by receiving doxycycline.

Complications

Complications of endometritis can be:

• Infections of wounds;
• Peritonitis;
• Infection of the uterus;
• An abscess in the pelvic area.

Forecast

In 90% of patients improvement occurs within 48-72 hours after initiation of treatment with antibiotics. If this does not happen, it is necessary to conduct re-examination - may have been misdiagnosed.

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