POSTPARTUM ENDOMETRITIS

Endometritis is an infection of the inner layer of the uterus (endometrial layer). During pregnancy, the innermost layer of the uterus changes and is called decidua. For several reasons after pregnancy, infection of this layer can develop and this is called postpartum endometritis. In endometritis, if the infection has advanced to myometrium, it is called endomyometritis, and if it has advanced to the parametrium, it is called parametritis.
Postpartum endoemetritis is a polymicrobial infection. A variety of bacteria may be involved, such as group B streptococci, anaerobic gram positive bacteria, anaerobic gram negative bacteria (bacteriodes, prevotella), aerobic gram negative bacteria (E. coli, K. Pneumonia, Proteus), K. Trochamatis, Mycoplasma. In early endometritis, the most common factor is Group B streptococci. Chlamydia is most common in late endometritis.
Risk factors:
- Young age
- First birth
- Prolonged labor
- PPROM, EMR
- Cesarean
- Low socioeconomic level
- Multiple vaginal examinations
- Amniotic fluid with excess meconium
- GBS colonization
- Bacterial vaginosis
- Manual removal of the placenta
Symptoms and diagnosis:
One of the important causes of fever in the postpartum period is endometritis. Apart from fever, there may be symptoms such as uterine tenderness, lower abdominal pain, foul-smelling discharge.
There is a leukocyte high in the blood. However, in the postpartum period, the height of leukocytes can be seen in the patient physiologically.
In addition, in terms of diagnosis, conditions such as wound infection, infection in the area of ​​episiotomy or hematoma, abscess development, mastitis, breast abscess, pyelonephritis and high postpartum fever should be considered.


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