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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.

Update Date: 8/5/2013

Updated by: 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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