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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.
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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)
- Childbirth (more common after C-section than vaginal birth)
Endometritis can occur at the same time as other pelvic infections.
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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)
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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:
- Cultures from the cervix for chlamydia, gonorrhea, and other organisms
- Endometrial biopsy
- ESR (erythrocyte sedimentation rate)
- Laparoscopy
- WBC (white blood count)
- Wet prep (microscopic exam of any discharge)
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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).
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Outlook (Prognosis)
In most cases, the condition goes away with antibiotics. Untreated endometritis can lead to more serious infections and complications.
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Possible Complications
Complications may include:
- Infertility
- Pelvic peritonitis (generalized pelvic infection)
- Pelvic or uterine abscess formation
- Septicemia
- Septic shock
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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
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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.
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References
Duff P, Birsner M. Maternal and perinatal infection in pregnancy: bacterial. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 54.
Gardella C, Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.
Smaill FM, Grivell RM. 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, Bolan GA; 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.
