What Is Postpartum Endometritis?

Postpartum endometritis is a bacterial infection in the uterine lining that may occur after childbirth. The symptoms typically include a fever, rapid heartbeat and pain in the uterus. Treatment usually consists of antibiotics, though they should be administered shortly after the symptoms begin because this condition can be fatal if not treated. Postpartum endometritis is rather rare and can be prevented by using antibiotics before a Caesarean section. Antibiotics are also used during treatment, because this type of medication can usually eliminate an infection within a few days.

This condition is caused by various kinds of bacteria, most commonly E. coli and group B streptococci, which travel from the mucosal lining of the vagina to the upper genital tract. In extreme cases, the bacteria infect the bloodstream, resulting in bacteremia. Blood clots and septic shock, which can be fatal, are other possible complications of postpartum endometritis. To prevent this outcome, the condition needs to be treated as soon as the common symptoms occur, so women who notice a fever, rapid heartbeat and uterine pain within three days of giving birth should see their doctor immediately. Other symptoms include pain in the lower abdomen, a foul-smelling vaginal discharge, and a generally ill feeling.

The risk of developing this condition increases with a Caesarean section, especially if the surgery was ordered after a long labor during which the membranes were ruptured. Other risk factors for postpartum endometritis include excessive examinations of the vagina, though a complete lack of medical care during and after the pregnancy can also increase the chances of this condition. Therefore, low-income women who cannot afford medical treatment tend to be at-risk for an infection of the uterine lining. In addition, the presence of a genital tract infection even before childbirth, often a result of gonorrhea or bacterial vaginosis, can also increase the odds of this condition after delivery. Young women are more likely than older females to get such an infection in the uterine lining.

Diagnosis of postpartum endometritis usually requires laboratory tests that look for an infection. These tests typically measure the number of white blood cells and also examine the urine for signs of infection. X-rays of the pelvis may also be ordered before diagnosing a woman with postpartum endometritis. Treatment is usually a course of single antibiotics given intravenously, though more serious cases often call for a combination of antibiotics to fight the infection. Treatment usually takes from two to three days, during which time most patients have to stay in the hospital to receive the intravenous drugs.