Endometrium swelling (endometritis) is inflammation of any of the layers of the uterus.
Normal bacteria from the cervix and vagina may enter the uterus, which can lead to inflammation and infection. The most common cause of endometrium swelling is the rupture of membranes during childbirth.
The uterus is a sterile environment until the amniotic sac ruptures during childbirth, when bacteria is more likely to enter damaged or bleeding uterine tissue where it can multiply. It is more common in patients who undergo Cesarean sections (C-sections).
In addition to a Caesarean delivery, risk factors for developing endometritis include:
- Inflammation of amniotic fluid and tissue (chorioamnionitis)
- Prolonged labor
- Membrane rupture
- Multiple cervical examinations
- Internal fetal monitoring
- Young maternal age
- Never giving birth before
- Low socioeconomic status
- Meconium-stained amniotic fluid
- Bacterial colonization of the lower genital tract with bacteria such as Group B streptococcus (GBS), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, or Gardnerella vaginalis
Endometritis is not the same condition as endometriosis, which is a common condition in which tissue similar to the lining of the uterus grows outside the womb, causing pelvic pain and fertility problems.
What Are Symptoms of Endometrium Swelling?
Symptoms of endometrium swelling (endometritis) may include:
- Abdominal pain
- Foul-smelling discharge
- Postpartum bleeding that contains pus (purulent lochia)
- Fast heart rate
- Low blood pressure (hypotension)
- In severe cases:
- Extreme pain
- Life-threatening infection (sepsis)
- Toxic shock
- Severe skin cellulitis
How Is Endometrium Swelling Diagnosed?
Endometrium swelling (endometritis) is diagnosed with a patient history in which risk factors are considered, and a physical examination.
Tests used to diagnose endometritis and its severity or to rule out other conditions that may cause similar symptoms include:
- Blood tests
- Complete blood count (CBC)
- Blood culture
- Cervical cultures
- Imaging tests
- Computed tomography (CT) scan
What Is the Treatment for Endometrium Swelling?
Treatment for endometrium swelling (endometritis) usually involves antibiotics to treat infection. One or more oral antibiotics may be used together for mild cases, such as:
In patients with moderate to severe endometritis or patients with endometritis after a Cesarean section, intravenous (IV) antibiotics and hospital admission are recommended. IV antibiotics may include:
- For patients unable to take clindamycin: piperacillin-tazobactam and ampicillin-sulbactam
- If no improvement is seen within 24 hours, ampicillin may be added
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