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Postpartum Endometritis in the ED setting: presentation, evaluation, and management

Endometritis is a clinical diagnosis. Imaging is not required for diagnosis; however, it may be useful to assess for retained products of conception or abscess formation. Imaging should also be considered in cases which do not respond to treatment. Ultrasound findings of endometritis include uterine enlargement, endometrial thickening, fluid within the endometrial cavity, indistinctness of the endomyometrial junction, and a subserosal hypoechoic rim. Many of these features are thought to overlap with a normal post-partum uterus. Air within the endometrial cavity is not diagnostic of infection and may be seen for several weeks post-partum. Computed Tomography (CT) shows similar findings but…

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Articles of Interest

Antibiotic regimens for postpartum endometritis

The combination of clindamycin and gentamicin is appropriate for the treatment of endometritis. Regimens with good activity against penicillin‐resistant anaerobic bacteria are better than those with poor activity against penicillin‐resistant anaerobic bacteria. There is no evidence that any one regimen is associated with fewer side‐effects. Following clinical improvement of uncomplicated endometritis which has been treated with intravenous therapy, the use of additional oral therapy has not been proven to be beneficial.

Antibiotic therapy for chronic endometritis and its reproductive implications: a step forward, with some uncertainties

During the last 2 decades, there has been growing interest in the study of endometrial pathologies and their reproductive implications. Chronic endometritis (CE), defined as the abnormal invasion of plasma cells within the endometrial stroma, has been one of the most investigated conditions.

Chorioamnionitis and Endometritis

Postpartum endometritis occurs when infection is not totally cleared out after delivery and affects the endometrium. Risk factors include chorioamnionitis, cesarean delivery, prolonged labor or ROM, manual placental removal, and all the chorioamnionitis risk factors above. The diagnosis is based on the presence of postpartum fever, along with tachycardia, uterine tenderness, foul smelling lochia, and/or leukocytosis. Treating endometritis occurs most commonly with clindamycin and gentamicin, with the addition of ampicillin (“triple therapy”) for GBS-positive patients.

Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome...

Chronic endometritis (CE) is a chronic inflammatory state of the endometrium caused by an abnormal endometrial microbiome. In recent years, a growing interest in CE has been seen, especially due to its putative role in infertility, recurrent pregnancy loss, and repeated IVF failures (RIF). Notably, in these conditions, CE prevalence has been often reported to exceed 30%.

Could chronic endometritis be causing your infertility?

If you suffer from infertility and have undergone a diagnostic workup, you may already know that your infertility is a sign that something else is wrong, a symptom of an underlying issue or disease. One possible culprit could be chronic endometritis (CE), a persistent inflammation of the endometrium, leading to ongoing, low-grade infection. (CE is not to be confused with endometriosis, the condition where the endometrial lining grows outside the uterus.)

EM@3AM: Endometritis

Endometritis in the ED is more likely to be an acute presentation; chronic endometritis is a less common presentation. Most acute endometritis cases occur after a cesarean section (C-section) 1-6 weeks postpartum. Endometritis is 10-30x more common after C-section vs vaginal birth.

What Every Woman Should Know About Endometritis (NOT Endometriosis)

Did you know that around 10% of women worldwide are affected by endometritis? Though it is quite common for people to mistake this condition for endometriosis because they both affect the uterus, they are very different.