Endometritis Flashcards
1
Q
What is post partum endometritis?
A
Infection of the decidua (i.e. pregnancy endometrium). May extend into myometrium.
2
Q
What are the common aetiologies of post-partum endometritis?
A
Polymicrobial involving 2-3 aerobes and anaerobes from the genital tract
3
Q
RFx for postpartum endometritis?
A
- LUSCS
- Chorioamnionitis
- Prolonged labour / ROM
- Multiple examinations
- Internal foetal monitoring
- Large meconium
- Manual removal of placenta
- Low SES
- GDM
- Preterm birth
- Operative vaginal delivery
- Post term pregnancy
- HIV infection
- GBS
4
Q
Key CFx in postpartum endometritis?
A
- Fever
- Tachycardia (parallels temperature)
- Midline lower abdo pain
- Uterine tenderness
Plus (in some): - purulent lochia
- chills /rigors
- HA / LoA / lethargy
5
Q
What infectious foci should be excluded prior to diagnosing endometritis?
A
- Surgical site infection (LUSCS, epis)
- Mastitis / abscess
- Pyelonephritis
- Aspiration pneumonia
- Complication of spinal / epidural
6
Q
Should endometrial culture be obtained?
A
No due to difficulty obtaining specimen through the cervix; results too late for clinical use.
7
Q
What Ix should be performed?
A
- Cervical / HVS for gonorrhoea and chlamydia if not done, previously positive, or high risk
- Endometrial sample not routine
8
Q
Abx for endoemtritis?
A
Need to cover beta-lactamase producing anaerobes.
IV Clindamycin + Gentamicin 24-48h and until no fundal tenderness
