Endometritis is inflammation of the inner lining of the uterus which is generally caused by infection. This condition is more at risk for women who have had a Caesarean section or a curettage. Endometritis needs to be treated immediately to prevent impaired fertility and the spread of infection to other organs.

Endometritis is different from endometriosis . Endometriosis is a condition when cells from the endometrium, which is the innermost layer of the uterus, grow outside the uterine wall. Endometritis is an infection or inflammation of the endometrium. Although different, the two conditions can cause infertility.

Causes of Endometritis

Basically, the uterus is a sterile organ. Endometritis occurs when bacteria enter the uterus and infect it. Types of bacteria that cause endometritis include Bacteroides, Peptococcus , Streptococcus , Enterococcus , E. coli , Gardenella vaginalis , and Staphylococcus aureus .

Endometritis generally occurs due to the entry of bacteria into the uterus during labor or after delivery. Some other conditions that can cause endometritis are:

  • Sexually transmitted diseases, such as chlamydia or gonorrhea
  • Spread of infection from bacterial vaginosis
  • Spread of tuberculosis infection leading to prolonged (chronic) endometritis

Endometritis risk factors

As mentioned above, endometritis occurs when bacteria enter the uterus. A number of factors that can increase the risk of this event are:

  • Delivery by caesarean section , because the uterus can come into contact with air or other factors outside the body
  • Medical procedures that involve the use of devices inserted through the cervix, such as hysteroscopy , spiral contraceptive installation, and curettes
  • Untreated premature rupture of membranes or prolonged labour
  • Postpartum bleeding
  • Amniotic infection ( chorioamnionitis )
  • Endometrial biopsy, which is taking a tissue sample from the lining of the uterus
  • Placenta or tissue left in the uterus after delivery or as a result of a miscarriage

Endometritis symptoms

Endometritis can cause a variety of symptoms. Common symptoms of endometritis include:

  • Fever
  • Abdominal swelling
  • Pain in the lower abdomen, pelvic area or rectum
  • Abnormal discharge
  • Bleeding from the vagina outside of menstruation
  • Pain when defecating
  • Constipation
  • Feeling unwell and fainting

When to see a doctor

Check with your doctor if you experience the above symptoms. You should seek medical attention immediately if symptoms of endometritis appear, especially after childbirth, miscarriage, spiral contraception, uterine surgery, and curettage.

Diagnosis Endometritis

To diagnose endometritis, the doctor will ask about the patient's symptoms, medical history, and history of childbirth or uterine surgery. After that, the doctor will carry out a physical examination, including a pelvic examination.

Furthermore, to establish a diagnosis, the doctor may perform further examinations in the form of:

  • Blood tests, to check for signs of infection in the form of an increased white blood cell count
  • Examination of fluid samples from the cervix (cervix), to detect bacteria that cause endometritis
  • Endometrial biopsy, to take samples of endometrial tissue which will then be examined in the laboratory
  • Laparoscopy , to see the inside of the abdomen so that the doctor can detect signs of infection more clearly

Endometritis Treatment

Treatment of endometritis depends on its cause and severity. If endometritis occurs after delivery, the patient will be given antibiotics through an IV and asked to be hospitalized.

Types of antibiotics that can be given by doctors are clindamycin , gentamicin, and ampicillin. Doctors can give one or a combination of the three antibiotics.

In mild symptomatic endometritis caused by other conditions, the doctor will give oral antibiotics. If endometritis is caused by a sexually transmitted disease , the doctor will also treat the patient's partner.

Endometritis complications

Endometritis that is not treated quickly and appropriately can cause serious complications in the form of:

  • Infertility
  • Pelvic peritonitis, which is a severe infection of the pelvic cavity
  • Abscess in uterus or pelvis
  • Sepsis
  • Septic shock

Endometritis Prevention

To prevent endometritis, your doctor will give you antibiotics before and after a curettage, cesarean section, or prolonged labor.

You can also lower your risk of endometritis independently, by taking the following measures:

  • Adopting a healthy sexual relationship
  • Undergo regular screening for sexually transmitted diseases
  • Take the antibiotics prescribed by the doctor if you have a sexually transmitted disease
  • Undergo routine pregnancy control
  • Perform routine checks if undergoing spiral KB installation
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