Endometritis is an inflammation of the inner layer of the uterus (endometrium) of various etiologies. In some cases, endometritis is asymptomatic, which makes it difficult to diagnose it in the early stages. Neglected endometritis leads to menstrual disorders, chronic diseases of the reproductive system and even infertility.
The uterus is a three–layered hollow organ. There are layers: endometrium, myometrium, parametrium. The parametrium is the outer serous membrane, the myometrium is the muscular layer, the endometrium is the inner mucous membrane consisting of two layers – the functional one, which is replaced with a new one every month. This process is called menstruation. The second layer of the endometrium is basal, due to it, the formation of a functional one occurs.
In endometritis, inflammatory processes occur in the endometrium (two layers) and in some cases in the myometrium.
CAUSES OF ENDOMETRITIS
According to the etiology, infectious and non-infectious endometritis are distinguished. Non-infectious endometritis occurs as a result of mechanical injuries during procedures:
Medical abortion
Diagnostic curettage in case of suspected oncology
Probing of the uterine cavity
Hysterosalpingography
Setting up intrauterine devices with contraceptive and therapeutic purposes
Violations of the douching algorithm
A separate group of non-infectious endometritis is postpartum endometritis, which occurs as a result of the restructuring of the immune and reproductive systems of women. Infectious endometritis is characterized by damage to the uterus by conditionally pathogenic flora, proteus, mycoplasma, Diphtheria bacillus, tuberculous mycobacterium, chlamydia, etc.
SYMPTOMS OF ENDOMETRITIS
The symptoms of endometritis in many women are sharply reduced or absent altogether. However, there are also characteristic clinical symptoms:
General malaise, symptoms of intoxication
Temperature rise to 39 0 C
Aching pains in the lower abdomen, can give to the sacrum, back. The pain may resemble premenstrual
Discharge of various types: serous, serous-purulent, with blood inclusions
When examined by a doctor, the uterus is enlarged and painful with palpation of a dense consistency
In laboratory analysis – increased ESR, leukocytosis with neutrophil shift to the left
Symptoms of endometritis develop 3-4 days after infection. The acute period of endometritis lasts up to 10 days. With inadequate treatment, endometritis becomes chronic.
CHRONIC ENDOMETRITIS
Chronic endometritis is accompanied by the formation of small cysts. And also:
Violation of the menstrual cycle
Acyclic bleeding of unclear etiology
Impossibility of implantation of the fetal egg into the endometrium, and, as a result, miscarriage, spontaneous abortions
Periodic serous or purulent discharge
Aching pains in the lower abdomen
Morphological changes of the uterus: enlargement, compaction, soreness
DIAGNOSIS OF ENDOMETRITIS
The diagnosis of “ENDOMETRITIS” is based on
gynecological examination with mirrors, palpation
of smears in case of suspected infectious endometritis
laboratory diagnostics: clinical and biochemical analysis
of ultrasound diagnostics of pelvic organs
complaints of the patient
chronic endometritis requires a longer diagnosis due to the difficulty of differentiating this disease with other gynecological diseases
TREATMENT OF ENDOMETRITIS
Acute endometritis requires versatile treatment. With infectious endometritis, broad-spectrum antibiotics are used, for example, Clindamycin, Cefoxitin, Cefoperazone and others, depending on the sensitivity of the microflora. In non-infectious endometritis, measures aimed at the speedy healing of the functional layer of the endometrium, vitamin therapy, immunomodulators are shown. Also, along with antibiotics, it is advisable to prescribe antihistamines, probiotics, antimycotic drugs.
In chronic endometritis, the treatment of opportunistic (concomitant) pelvic diseases, extragenital diseases, and general strengthening of the body is of great importance. In the subacute period, physiotherapy, physical therapy, massage, which improves blood circulation of the pelvis, have a positive effect.
