Endometritis

Question 1

What is endometritis?

Answer 1

Infection of endometrium

Question 2

What is the aetiology of endometritis?

Answer 2

Ascending infeciton from lower genital tract, may occur secondary to inflammation of uterus.

RF

· Ob: C section, PROM, prolonged labour, retained products of conception, manual removal of placenta,

· Gynae: PID, infection (chlamydia, bacterial vaginosis, TB) instrumentaiton of uterus (i.e. TOP)

Question 3

What is the epidemiology of endometritis?

Answer 3

3% after vaginal delivery. 30% after CSEC.

Question 4

What is the Hx/ Ex findings of endometritis?

Answer 4

Fever, abdo pain, offensive discharge, lochia, dyspareunia.

General: pyrexia, tachycardia.

Abdo: lower abdominal tenderness.

Vaginal: offensive discharge, uterine tenderness, adnexal tenderness.

Question 5

What is the pathology of endometritis?

Answer 5

· Acute: neutrophils in endometrial glands

· Chronic: plasma cells and lymphocytes in endometrial stroma.

· PathogensL G+ Staph, strep. G- Ness, E coli, Proteus, Enterobacter, Gerdnerella). Anaerobes (bacteroides)

Question 6

What Ix do you do for endometritis?

Answer 6

Blood: FBC, CRP/ESR, WCC,

MCSL HVS, endocervical and chlamydia swab, blood culture.

Question 7

What is the management of endometritis?

Answer 7

BSABx. Surgery may be indicated if RPC (after 24h Abx).

Question 8

What are complications/ prognosis of endometritis?

Answer 8

90% resolve in 48-72h with ABX.