Postpartum Endometritis Treatment

Postpartum endometritis is an infection of the uterine lining that occurs after delivery of a child (indicated by the term "postpartum"). It affects 1-3% of women who give birth via vaginal delivery, and 5-15% of women who deliver via scheduled cesarean section. Up to 35% of women who undergo a cesarean section after prolonged labor conditions develop a postpartum endometritis infection.

Causes and Symptoms

• Postpartum endometritis is caused by bacteria that generally already live within the vaginal cavity, cervix, or bowel. The uterus is generally sterile (barring other complications) until the amniotic sac is torn, and infection occurs under the stress of delivery or during surgical excision of the fetus. Several different species of bacteria can be the infectious agent, but the culprit is generally streptococcus or E. coli. if not treated rapidly, the infection can spread to other areas of the body, including the blood, and if left untreated for long enough, can be fatal.

  Patients with a postpartum endometritis infection generally present with symptoms typical of a bacterial infection. This includes fever and a general feeling of unwellness, and a rapid heartbeat, and usually occur within 36 hours of hospital discharge after giving birth. Discomfort in the abdomen, tenderness of the uterus, and an odorous vaginal discharge are also common symptoms. If the infection spreads to the tissues connected to and adjacent to the uterus, pain can become quite severe.

Treatment and Prognosis

• The most effective treatment of postpartum endometritis is prophylactic. Before delivery, especially if an unanticipated cesarean section is to be performed, a doctor may administer an antibiotic in order to prevent postpartum endometritis, and it has been shown to be effective in studies. If treated after symptoms are present, different classes of IV antibiotics (cephalosporins, penicillins, and carbapenems) can be used to combat the infection before it becomes systemic and spreads to other parts of the body. In more severe cases, a combination of antibiotic treatments may be used.

  If not found and put under control quickly, postpartum endometritis can be fatal due to the resulting systemic infection and septic shock. While it is possible, death via a postpartum endometritis infection is increasingly rare, especially in the United States, although in poorer areas the mortality rate can be higher. For most new mothers who have been diagnosed with an infection, treatment is generally fast-acting and the prognosis is good. Again, swift treatment is important, as allowing the infection to spread to other organ systems or the blood can lead to septic shock and death.