Postpartum Endometritis: Causes, Symptoms, Diagnosis And Treatment

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Postpartum endometritis is a bacterial infection some women develop after childbirth. The infection usually affects the inner lining of the uterus (endometrium) (1). Though postpartum endometriosis isn’t a serious health condition, it often requires antibiotic therapy to avert complications. Early diagnosis and prompt treatment help in the early resolution of the problem.

Keep reading to learn more about postpartum endometritis and its causes, symptoms, risk factors, diagnosis, and treatment.

Causes Of Postpartum Endometritis

Both aerobic and anaerobic bacteria can cause chronic endometritis. Some pathogens responsible for it are Clostridium, Staphylococcus, and Escherichia coli. Most of these bacteria enter the endometrial cavity through the genital tract during labor contractions and at the time of vaginal deliveries but more often during cesarean delivery.

Endometritiscould also be contracted after a miscarriage, abortion, or intrauterine device (IUD) implantation. In the case of chlamydia endometritis, the symptoms usually occur about seven or more days after delivery (2).

Signs And Symptoms Of Postpartum Endometritis

The most common symptoms of postpartum endometritis include fever and discomfort or tenderness in the vaginal area. The other signs and symptoms of endometritis may include (1) (3).

  • Lower abdominal pain or swelling
  • Foul-smelling vaginal discharge and bleeding
  • Pain while urinating
  • Difficult bowel movements

If you notice any of these symptoms post-delivery, consult your doctor for further information and prevent any future complications.

Risk Factors For Postpartum Endometritis

The common risk factors for postpartum endometritis include (1) (3) (4).

  • Prolonged labor
  • Improper prenatal care
  • Prolonged gap between the rupture of the amniotic sac and delivery of the baby
  • Internal examinations during pregnancy
  • Manual removal of the placenta by the doctor
  • Using an intrauterine device
  • Presence of meconium (fetal stool) in the uterus
  • Bacterial infestation in the vaginal flora before delivery or labor
  • Surgical site infections during delivery

Diagnosis Of Postpartum Endometritis

Postpartum endometritis is primarily diagnosed by observing the symptoms and conducting a thorough physical examination of the vaginal area. The doctor may suggest urine or blood tests, wet prep, or laparoscopy for further confirmation (1) (4).

Treatment For Postpartum Endometritis

Postpartum endometritis can be treated with oral antibiotics. Clinical findings suggest that the combination of clindamycin and gentamicin show positive results (5). Your doctor may also recommend ampicillin with other antibiotics.

Note that you should only take these medications as per prescription. Self-treatment may lead to serious repercussions.

Complications Of Postpartum Endometritis

According to the World Health Organization (WHO), women who have been exposed to bacteria causing chronic endometritis are prone to disabilities such as chronic pelvic pain, blockage in the fallopian tubes, and secondary infertility, leading to recurrent abortions (6).

If diagnosed at an early stage, postpartum endometritis can be treated with antibiotics. However, if the infection is not diagnosed and persists, it may spread throughout the blood, leading to septicemia (1).

Prevention Of Postpartum Endometritis

Studies have shown that prophylactic antibiotic therapy could reduce the chances of postpartum endometritis by around 60% (7). In addition, proper prenatal care before delivery helps reduce the risk of postpartum endometritis (3).

Postpartum endometritis is a common infection occurring in women, especially those who had a cesarean mode of delivery. If diagnosed at an early stage, it can be cured with antibiotic treatment. However, if a timely diagnosis is not made, it may lead to health complications. Hence, consult your gynecologist if you experience discomfort or suspect any symptoms.


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Sanjana Bhattacharjee

Sanjana did her post graduation in Applied Microbiology from Vellore Institute of Technology, India. Her interest in science and health, combined with her passion to write made her convert from a scientist to a writer. She believes her role at MomJunction combines the best of both worlds as she writes health-based content based on scientific evidence. Sanjana is trained in classical... more