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Chapter 30 - Puerperal Endometritis

from Section 3 - Postpartum Infections

Published online by Cambridge University Press:  11 October 2019

By
Christine Helmy Samuel Azer
Edited by
Adel Elkady ,
Prabha Sinha  and
Soad Ali Zaki Hassan
Adel Elkady
Affiliation:
Police Force Hospital, Cairo
Prabha Sinha
Affiliation:
Oman Medical College, Oman
Soad Ali Zaki Hassan
Affiliation:
Alexandria University
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Summary

Endometritis refers to infection of the decidua (endometrium). The infection may also extend into the myometrium (endomyometritis) or involve the parametrium (parametritis).

Commonly isolated organisms include Ureaplasma urealyticum, Peptostreptococcus, Gardnerella vaginalis, Bacteroides bivius and group B Streptococcus.

Chlamydia has been associated with late-onset postpartum endometritis.

Enterococcus is identified in up to 25 per cent of women with puerperal endometritis.

Ascending infection from the vagina is the main mechanism.

The highest incidence is during childbirth: 1–3 per cent of vaginal births, and up to 27 per cent of caesarean births. In the USA the incidence after caesarean section ranges from 13 to 90 per cent, depending on the risk factors present and whether perioperative antibiotic prophylaxis had been given.

Type
Chapter
Information
Infections in Pregnancy
An Evidence-Based Approach
 , pp. 180 - 182
Publisher: Cambridge University Press
Print publication year: 2019

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References

‘Endometritis’ at Dorland’s Medical Dictionary.Google Scholar
Chen, KT. Postpartum endometritis. UpToDate. www.uptodate.com/contents/postpartum-endometritis.Google Scholar
Rivlin, ME, Alderman, E, Chandran, L, Simmons, GT. Endometritis. Medscape. Updated 1 December 2017. https://emedicine.medscape.com/article/254169-overview.Google Scholar
Moldenhauer, JS. Puerperal Endometritis. MSD manual. www.msdmanuals.com/professional/gynecology-andobstetrics/postpartum-care-and-associated-disorders/puerperal-endometritis.Google Scholar
Cicinelli, E, Matteo, M, Tinelli, R et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Human Reproduction. 2015; 30(2): 323–30,Google Scholar
Mackeen, A, Packard, RE, Ota, E, Speer, L. Antibiotic regimens for postpartum endometritis. Cochrane Database Sys Rev. 2015: 2: CD001067. doi: 10.1002/14651858.CD001067.CrossRefGoogle Scholar
World Health Organization. Recommendations for Prevention and Treatment of Maternal Peripartum Infection. Geneva. 2015. http://apps.who.int/iris/bitstream/10665/186171/1/9789241549363_eng.pdf?ua=1.Google Scholar

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