Endometritis

Snap Shot

• A 24-year-old G3P3 female presents three days following Cesarean section with fever. Physical examination reveals uterine tenderness and laboratory results show elevated white blood cell count. 

Introduction

• Infection of the uterus post-partum or post-abortion
• Can be acute or chronic
  • acute
    • most commonly of bacterial origin
      • Group B strep (usual cause) 
      • other causes include S. aureus, B. fragilis, and C. trachomatis
  • chronic
    • most commonly of bacterial origin due to retained placenta or IUD
      • N. gonorrhoeae
      • A. israelii (IUD) 
• treat with penicillin

Presentation

• Symptoms
  • vaginal discharge
  • abdominal pain
• fever

Evaluation

• Histology
• plasma cells

Treatment

• Pharmacologic
  • cefoxitin
  • ampilicillin-sulbactam
  • ticarcillin-clavulanate