puerperal endometritis


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Related to puerperal endometritis: Puerperal sepsis

endometritis

 [en″do-me-tri´tis]
inflammation of the endometrium.
puerperal endometritis endometritis following childbirth.
syncytial endometritis a benign tumorlike lesion with infiltration of the uterine wall by large syncytial trophoblastic cells.
tuberculous endometritis inflammation of the endometrium, usually also involving the fallopian tubes, due to infection by Mycobacterium tuberculosis, with the presence of tubercles.

puerperal endometritis

Acute endometritis following childbirth. Risk factors for development of this condition include premature or prolonged rupture of membranes, dystocia with multiple vaginal examinations, poor aseptic technique, trauma related to intrauterine manipulation, and careless perineal care. Constitutional factors that predispose the parturient woman to endometritis include anemia, malnutrition, and hemorrhage. Portals of bacterial entry include the site of previous placental attachment, episiotomy, lacerations, and abrasions.

Etiology

Aerobic organisms include streptococci, Gardnerella vaginalis, Escherichia coli, Staphylococcus aureus, and group A β-hemolytic streptococci. Endometritis that occurs late in the postpartal period is most commonly caused by Chlamydia trachomatis.

Symptoms

Abdominal tenderness is common. Severe endometritis may cause fever, chills, tachycardia, extreme uterine tenderness, and subinvolution. Although a moderate-to-profuse foul-smelling vaginal discharge usually is seen, the lochia of women infected by β-hemolytic streptococci is scant, odorless, and serosanguineous to serous.

Treatment

Antibiotics that treat aerobic and anaerobic bacteria are administered, usually for a 4- or 5-day course. Supportive therapy includes bedrest, analgesics, and oral and IV fluids.

See also: endometritis
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