The uterus, generally known as the womb, is the
most delicate organ of woman. Various kinds of disorders can occur in
his and the most common occurrence is the inflammation of the uterus,
which can either be sensitive or chronic. The inflammation of the
Uterus, which may affect the delicate lining membrane of the uterus, is
called Endometritis.
Endometritis is an infection of the endometrium, with extension into
the myometrium and parametrial tissues. Endometritis is divided into
obstetric and nonobstetric endometritis. It is the most common cause of
fever during the postpartum period. Pelvic inflammatory disease (PID)
is a common predecessor in the nonobstetric population.
This is more common in females during their reproductive age.
Causes-
Endometritis is caused by infections such as chlamydia, gonorrhea,
tuberculosis, or mixtures of normal vaginal bacteria. Endometritis is
more likely to occur after childbirth, miscarriage, or placement of an
intrauterine device (IUD).
Any surgical procedure that enters the uterus through the cervix will
increase the risk of developing endometritis. Endometritis can occur at
the same time as other pelvic infections such as acute salpingitis,
acute cervicitis, and many sexually transmitted diseases (STDs).
Morbidity/ Mortality
- Infection of the genital tract is the most common cause of
puerperal morbidity. Puerperal morbidity is defined as a temperature of
100.4°F (38°C) or higher occurring in any 2 of the first 10 days
postpartum, exclusive of the first 24 hours. In the past, infection
accounted for up to 16% of maternal mortality.
- In the nonobstetric population, concomitant endometritis
may occur in up to 70-90% of documented cases of salpingitis.
Symptoms-
1.Abdominal distention
2.Abnormal vaginal bleeding
3.Abnormal vaginal discharge
a.Increased amount
b.Unusual color, consistency, or odor
4.Discomfort with bowel movement (constipation may occur)
5.Fever (ranging from 100 to 104 degrees Fahrenheit)
6.General discomfort, uneasiness, or ill feeling (malaise)
7.Lower abdominal or pelvic pain (uterine pain)
Signs and tests:
The health care provider will perform a physical exam and a pelvic
exam. The lower abdomen may be tender. Bowel sounds may be decreased. A
pelvic exam may cause the uterus and cervix to feel tender. There may
be cervical discharge.
Other problems to be considered
1.Appendicitis
2.Pelvic Inflammatory disease
3.Pyelonephritis
4.Thrombophlebitis
5.Viral syndrome
Investigations-
Laboratory Studies
1.On complete blood count the finding of leukocytosis may be difficult
to interpret, secondary to the physiologic leukocytosis of pregnancy.
2.Blood culture is positive in 10-30% of cases.
3.Urine culture should be ordered.
4.Endocervical cultures (or DNA probe) are obtained for gonorrhea and
chlamydia.
Imaging Studies
1.Perform imaging studies on patients who do not respond to adequate
antimicrobial therapy in 48-72 hours.
2.CT scanning of the abdomen and pelvis may be helpful for excluding
broad ligament masses, septic pelvic thrombophlebitis, ovarian vein
thrombosis, and phlegmon.
3.Sonographic findings of the abdomen to diagnosed it.
Complications-
1.Infertility
2.Pelvic peritonitis (generalized pelvic infection)
3.Pelvic or uterine abscess formation
4.Septicemia
5.Septic shock
Prognosis-
Most cases of endometritis go away with antibiotics. Untreated
endometritis can lead to more serious infection and complications with
pelvic organs, reproduction, and general health.
Treatment-
1.Medications.
2.Diet- the diet should aim at increasing general vitality when in the
chronic form.
3.Exercise- Exercises and Asanas also cure inflammation of the uterus
steadily. The patient should also undertake moderate exercise and
walking in fresh air, as it will help increase general health and
vitality.
4.Complicated cases (those occurring after childbirth or involving
severe symptoms) may require the patient to be admitted to a hospital.
Intravenous (in the vein) antibiotics are usually needed, followed by
antibiotics taken by mouth.
5.Rest and hydration are important.
6.Treatments for sexual partners, when appropriate, and the use of
condoms throughout the course of treatment, are essential.
Role of homoeopathy
Homeopathy is a safe, natural form of medicine, based on the practice
of treating like with like. The homeopath will consider the patient as
a whole, both physically and psychologically and help cure the metritis.
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