Endometritis
Endometritis is an inflammation of the uterine mucous layer, which is called the endometrium. This uterine membrane does not have a regular structure, since it constantly changes during the menstrual cycle. At the end of each cycle, the endometrium grows and matures to prepare for the attachment of an egg that has undergone fertilization. If pregnancy has not occurred, then it is rejected by the cell. Often the inflammatory process occurs with concomitant inflammation of the uterine muscle tissue, which is called endomyometritis. When the inflammation reaches the basal layer of the endometrium, it is called basal endometritis.
The content of the article:
Endometritis after childbirth
Acute endometritis
What is chronic endometritis?
The risk of endometritis
Symptoms of acute endometritis
Diagnosis of endometritis
Treatment of endometritis
Treatment regimen for chronic endometritis:
Complications and prevention of endometritis
Endometritis
The uterine cavity is under reliable protection of the endometrium from various pathogens of infectious diseases, but with certain deviations, infections enter the uterus anyway, which leads to inflammation — endometritis.
Endometritis is considered an infectious disease because the infection gets from the vagina into the uterus, which causes the development of sexually transmitted diseases and vaginal dysbiosis. When a woman’s immune system is in a weakened state, the body cannot fight viruses on its own. The spread of infection occurs quickly and eventually it can cover the uterine lining in full. Treatment that is not prescribed in time will allow the infection to spread to the muscular membrane and tubes of the uterus, and sometimes even go into the abdominal cavity with the further development of peritonitis.
Primary infection of the uterus can occur at a doctor’s appointment during curettage of the uterus or the introduction of an intrauterine device.
Acute endometritis is manifested due to inflammation of the mucous epithelium of the uterus through infection from the cervical barrier into the uterine cavity.
The manifestation and further development of acute endometritis provoke abortions, childbirth, curettage of the uterine cavity and any interference with the uterus.
Endometritis after childbirth
In the postnatal period, infectious cells are able to develop particularly quickly, so most women suffer from postpartum endometritis. According to statistics, postpartum endometritis occurs in 20% of women who gave birth on their own and in 40% who underwent cesarean section. This prevalence of the disease is caused by hormonal stress and the restructuring of a woman’s immune system during pregnancy, which leads to a decrease in resistance to viruses.
Postpartum endometritis develops after the birth of a child and is detected during ultrasound examination. The causes of endometritis in women who have given birth are:
gestosis and its accompanying signs (hypertension, swelling, increased protein levels in urine);
prolonged labor, which led to a large anhydrous interval;
incorrect location of the fetus in the womb or its large size;
narrow pelvis of a woman in labor;
late or early childbirth;
placental exfoliation ahead of time;
introduction of the pathogen during childbirth.
Often a complication in the form of endometritis appears in women who smoke during pregnancy.
The causative agent of endometritis can be bacteria, viruses, fungi, parasites and mixed flora.
Acute endometritis
The nature of the origin of acute endometritis can be specific and nonspecific. Specific endometritis occurs from viruses, chlamydia, bacteria, fungi and parasites. Inflammation can become a reaction to the simplest herpes, tuberculosis mycobacterium, etc. A complication of acute endometritis can cause a decrease in immunity, a violation of the endocrine system and constant stressful situations.
Nonspecific endometritis occurs without pathogenic flora in the uterine cavity. Most often, this form of endometritis occurs due to the appearance of bacterial vaginosis, HIV infection, the presence of a spiral or taking inappropriate contraceptives on a hormonal basis.
What is chronic endometritis?
The first symptoms of chronic endometritis are bleeding of the uterine cavity, which appear regardless of the day of the menstrual cycle. Naturally, the cycle also changes, so menstrual discharge may disappear or be released in small amounts. Chronic inflammation of the uterus can cause infertility.
The study of chronic endometritis is based on the processing of analysis data, the results of an ultrasound examination of the uterus, and hysteroscopy.
The treatment of acute endometritis is to increase immunity and treat secondary diseases. If chronic endometritis causes complications, then the doctor may prescribe antimicrobial agents.
Experts identify several reasons for the development of chronic endometritis:
the development of inflammatory processes of the genitourinary organs, the infection of which can pass into the uterine cavity;
abortion or premature birth, which contributed to the introduction and development of the primary pathogen;
chronic diseases of the fallopian tubes, accompanied by inflammation;
gynecological operations.
The risk of endometritis
Endometritis is observed in patients with weakened immunity: the immune system cannot cope with pathogens that penetrate the uterus and its appendages. The following factors affect the manifestation of the disease:
ruptures received by a woman during childbirth, which could provoke infection;
violation of the natural vaginal environment;
menstruation, childbirth and abortions cause a decrease in the protective function of the vaginal environment;
IUD (intrauterine device) due to a long stay in the uterine cavity contributes to the relocation of infection along the threads of the intrauterine contraceptive;
improper use of tampons during menstruation: the tampon can be in the cavity for no more than 4 hours. If tampons are used incorrectly, a toxicological shock may occur;
stressful situations and insufficient care of the external genitals;
overwork and lack of regular nutrition.
Symptoms of acute endometritis
Acute endometritis manifests itself within a few days after the pathogen enters the uterine cavity. The development of inflammation is accompanied by fever, unpleasant discharge from the genitals, urination with painful sensations, chills and increased pulse.
The presence of an intrauterine device in a woman can complicate the course of the disease. At the first signs of endometritis, you need to immediately undergo an examination by a gynecologist, who will be able to determine what causes the enlargement of the uterus and uncharacteristic discharge. Proper treatment of acute endometritis can last up to 10 days and have a favorable prognosis. If no methods are used to eliminate inflammation, it will turn into a chronic form.
Chronic endometritis has only two symptoms: a violation of the menstrual cycle and a woman’s reproductive function.
During the development of chronic endometritis, patients notice irregular menstrual discharge, which may disappear over time. Painful bleeding is observed before and after menstruation.
Often women suffer from infertility, the cause of which is acute endometritis. According to statistics, every tenth woman on this planet cannot get pregnant precisely because of the presence of an inflammatory process in the uterus.
Sometimes the presence of endometritis is indicated by pain in the lower abdomen, with complaints about which a woman turns to a gynecologist. During the examination, the specialist will identify other symptoms of uterine endometritis: enlargement and consolidation of the uterus. Purulent and serous discharge may also indicate the presence of chronic endometritis.
Diagnosis of endometritis
Diagnosis of endometritis involves the determination of the main symptoms. Timely and effective treatment enables the patient to conceive and bear a child. An initial examination by a gynecologist helps to determine the presence of endometritis at an early stage. A woman should tell the doctor about all the symptoms that bother her. Already at the initial stage, it will be possible to determine the presence of inflammation. Descriptions of exciting symptoms are not enough, so the doctor will still examine the uterus on the gynecological chair and visually assess its condition. Then it is necessary to take swabs to identify the pathogens of infections. The study of bacterial culture will help to identify the main group of bacteria that provoke the development of endometritis. The results obtained will help to choose the right treatment and determine the appropriate antibiotics. A general blood test will show the presence of an inflammatory process in the body. The degree and level of development of the disease is determined by ultrasound examination of the uterine cavity and its appendages.
Echography, probing and hysteroscopy can be used to confirm the diagnosis. To exclude oncological diseases of the internal reproductive system, a scrape is taken from the walls of the uterus.
Treatment of endometritis
Treatment takes place exclusively in a medical institution under the constant supervision of a doctor. The patient is recommended bed rest, proper nutrition, rich in vitamins and trace elements, rest. The main treatment of acute endometritis is based on the constant use of antibiotics and painkillers. The doctor calculates such a dose of drugs so that the greatest concentration is in the focus of infection. In order to exclude the development of fungal infections, the use of probiotics and antifungal agents is indicated. In the presence of several pathogens, complex treatment is carried out using several types of antibiotics. Metronidazole is prescribed for the prevention of anaerobic infection. Detoxification of the body consists in the use of large volumes of special solutions that are administered intravenously.
During the recovery period, a woman is prescribed various physiotherapy procedures.
Doctors are also considering a not quite traditional method of treating endometritis — the effect of cold on the area near the pubis. This method is based on the fact that receptors are activated during cooling, which will help relieve pain and can have an anti-inflammatory effect.
Treatment of chronic endometritis consists in a total change in the usual lifestyle in order to improve the state of the body’s immune system. Doctors believe that the treatment of chronic endometritis should be comprehensive.
With effective treatment, there is a significant improvement in the condition of the endometrium, a decrease in the level of exposure to the inflammatory pathogen, the chances of conceiving and carrying a child increase significantly, pain and discomfort stop, menstruation stabilizes.
Treatment regimen for chronic endometritis:
Stage 1 is to eliminate infectious pathogens;
Stage 2 is aimed at restoring the endometrium with the use of antibiotics;
Stage 3 helps to eliminate reproductive function disorders: the use of hormonal and metabolic therapy.
The main role in the treatment of acute endometritis is long-term physiotherapy aimed at strengthening the pelvis, reducing the functions performed by the ovaries and increasing the activity of the endometrium. Antibiotic drugs can be used only in cases of exacerbation of the disease.
To achieve the best effectiveness of medication treatment, they can be injected directly into the uterine lining. In this case, specialists will be able to achieve the maximum concentration of the drug in the foci of infection. If, during the treatment of endometritis, bleeding is detected in the uterine cavity, then hormonal hemostasis is performed and the solution is injected into the uterine cavity.
After eliminating the main symptoms of chronic endometritis, doctors advise to undergo sanitary and spa treatment in order to consolidate the result and improve the body. In order for the treatment to be thorough, it is necessary to conduct an examination of the sexual partner in order to avoid re-infection with the infection during sexual intercourse.
Many women hope to eliminate endometritis by resorting to traditional medicine, which offers to treat inflammation with infusions of various medicinal herbs.
Complications and prevention of endometritis
Changes in the endometrium with endometritis can provoke the formation of serious complications during the period of carrying a child: termination of pregnancy, postpartum bleeding. After endometritis, a woman should carefully monitor her health and regularly visit a gynecologist, especially when planning a pregnancy. The consequences of endometritis can also be adhesive intrauterine processes, menstrual cycle disorders, the formation of polyps and endometrial cysts. Inflammation of the endometrium can spread to other organs, which entails peritonitis and adhesive disease leading to infertility.
Prevention of endometritis consists in careful hygienic care, especially during menstruation and in the postnatal, post-abortion periods. When having sex, it is necessary to use condoms, this will protect against unwanted pregnancy and subsequent abortion, reduce the possibility of infection with sexually transmitted diseases.
Timely treatment of uterine endometritis is a favorable prognosis for pregnancy planning and subsequent delivery.
