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Endometritis

  • Definition
    • 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)

      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
  • 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
  • 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. Maternal and perinatal infection -- bacterial. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 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: Elsevier Mosby; 2012:chap 23.

      Smaill FM, Gyte GM. 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, Berman S; 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.