Endometritis

Endometritis is an inflammation of the endometrium, the lining of the uterus. The condition can be chronic or acute, and develops when there is a uterine infection. Such an infection may occur as a result of childbirth, surgical intervention, and sexually transmitted disease. While most cases of endometritis can be effectively treated with antibiotics, the condition can be serious, even life-threatening, if left untreated.

Causes of Endometritis

There are various causes of this disorder. These include:

  • Childbirth
  • Miscarriage
  • Placement of intrauterine device (IUD)
  • Sexually transmitted diseases (STD), such as chlamydia and gonorrhea
  • Tuberculosis
  • Gynecologic surgery or procedure

The uterine infection that causes endometritis can be caused by any number of diseases, which may include some that are sexually transmitted, and some that are not. The infection can also result from a proliferation of bacteria normally found in the vagina. In such cases, transmission of bacteria to the uterus is likely to occur during a long labor or a Cesarean section, or during any interventional pelvic procedure, such as the placement of an IUD, a dilatation and curettage (D and C), or an endometrial biopsy or hysteroscopy.

Symptoms of Endometritis

Some of the symptoms of endometritis are common to other disorders, so the condition may not be readily diagnosed. These symptoms include:

  • Abdominal swelling
  • Abnormal vaginal discharge or bleeding
  • Constipation or pain during bowel movements
  • Fever
  • Malaise

Patients with endometritis frequently experience pain in the abdomen or uterine pain in the pelvic region.

Diagnosis of Endometritis

If the gynecologist suspects endometritis, several steps are taken. First, the doctor performs a general physical examination. One indication of endometritis may be an absence of normal bowel sounds. Next, a pelvic examination is performed to check for uterine or cervical tenderness and possible cervical discharge. In addition, in order to definitively diagnose endometritis, one or more of the following tests are performed or administered:

  • Cervical cultures for chlamydia, gonorrhea and other STDs
  • Endometrial biopsy
  • Hysteroscopy
  • Microscope examination of any discharge
  • Laparoscopy, possibly with biopsy
  • Vaginal ultrasound
  • Pelvic CT scan
  • Blood tests

In order to diagnose endometritis, blood samples are checked for an elevated white blood cell count, which is a sign of infection, and an erythrocyte sedimentation rate (ESR), which is a sign of inflammation.

Treatment for Endometritis

Endometritis is treated, as are most infections, with the following:

  • Antibiotics
  • Increased fluid intake
  • Rest

If the condition manifests as severe or occurs after childbirth, the patient may require inpatient treatment with intravenous hydration. If the disorder is found to be the result of a sexually transmitted disease, sexual partners must be contacted and informed.

Complications of Endometritis

Left untreated, endometritis can present a serious risk. If the patient is not treated with antibiotics, of if the antibiotics are not effective, the infection may spread, causing one or more of the following:

  • Abscess formation
  • Peritonitis
  • Infertility
  • Septicemia
  • Septic shock

Septic shock, though a rare result of endometritis, carries a high risk of fatality.

Additional Resources