Endometritis - Causes, Symptoms And Treatment Of Endometritis In Women

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Endometritis: symptoms and treatment

Women often face the diagnosis of endometritis after undergoing surgery on the genitals, after an abortion or other traumatic procedure. You should not despair, as you can get rid of endometritis.

Endometritis is an inflammation of the mucous membrane that lines the uterus from the inside. This shell is called the endometrium. It flakes off every month. This happens during menstruation. During the next cycle, the endometrium grows again. This is necessary in order for the egg to be able to attach to it, and the woman was able to become pregnant. If no renewal occurs, then the fertilized egg will be rejected.

The endometrium has a barrier function. It protects the uterus from various infections. When these functions are reduced, the pathogenic flora gets inside and begins to multiply there. This leads to inflammation, which will be characterized by the doctor as endometritis.

The disease can be acute, or go into a chronic phase. The inflammation can spread to the uterine appendages and ovaries and cause serious health problems. Young women of childbearing age are more likely to suffer from endometriosis.

Differences between endometritis and endometriosis. With endometritis, inflammation captures the membrane lining the uterus from the inside. With endometriosis, the inflammatory process goes beyond the uterus. Connecting cords grow on adjacent organs.

Content:

• Endometritis causes

  • Endometritis causative agents
  • Causes of acute endometritis
  • Causes of endometritis in the postpartum period
  • The reasons for the development of chronic endometritis
  • Other causes of endometritis

• Endometritis symptoms

  • Common symptoms
  • Acute symptoms
  • Chronic symptoms
  • Symptoms after childbirth
  • Symptoms after a cesarean section
• Endometritis diagnostics

• Endometritis treatment

  • Acute treatment
  • Treatment of the chronic form
  • Drug therapy
  • Treatment of a purulent form
  • Endometritis surgery
  • Treatment of endometritis that develops after childbirth
• Prevention of endometritis
• Is pregnancy possible after endometritis?

Endometritis causes

Most often, various manipulations that are carried out on the uterus lead to endometritis. They can have a therapeutic or diagnostic purpose.

Normally, the endometrium has sufficient protection against pathogenic flora. It has 2 layers: basal and functional. When the next menstrual cycle ends, the functional membrane begins to recede. The new endometrium is formed from the basal layer. This process causes menstruation. If the lining of the uterus is damaged, then bacteria and viruses can easily get inside.

Factors such as the following can lead to a violation of the integrity of the uterine mucosa:

• Postponed abortions.
• Childbirth.
• Probe positioning.
• Scraping.
• Hysteroscopy.
• Douching if it is not done according to the rules.

All of these procedures can damage the inner layer of the uterus and facilitate the access of pathogenic flora to its deep structures. The danger in this regard is represented by such microorganisms as: enterobacter, mycoplasma, E. coli, chlamydia, proteus, etc. Endometriosis often develops after the birth of a child. In this case, the method of delivery is important. If the child was born naturally, then the probability of developing endometriosis is equal to 3%, with a cesarean section - to 15%. When the surgery was unplanned or performed on an emergency basis, the chance of developing endometriosis is 20%.

There are additional risk factors that can lead to the development of endometritis:

• Deterioration of human immunity.
• Chronic diseases.
• Intrauterine device placement.
• Injury to the uterus.
• Vitamin deficiency.
• Poor hygiene skills.
• Intimacy during menstruation.
• Sexual infections.
• Hormonal imbalance.
• Carrying out diagnostic and therapeutic procedures on the uterine cavity.

First of all, women who have weakened immunity suffer from endometritis. Defense mechanisms are unable to resist infection. Therefore, bacteria freely penetrate into the mucous layer of the uterus and multiply there.

Endometritis causative agents

Uterine endometritis does not develop on its own. It is caused by pathogenic flora:

• Conditionally pathogenic microorganisms that are activated when the body's defenses are reduced.
• Microbes that cause genital infections.
• Trichomonas and gonococci.

Most often, the disease develops when several representatives of the pathogenic flora are exposed to the uterine mucosa. These can be colonies of staphylococci, streptococci, viruses, fungi, etc.

Harmful microbes enter the uterus through the cervix from the vagina. They can also spread from the fallopian tubes, from the intestines. Sometimes they enter the uterus with blood or lymph flow.

Causes of acute endometritis

Acute endometritis can develop in the following cases:

• Diagnostic curettage of the uterus.
• Performing operations on the uterine cavity.
• Postponed abortion.
• Accumulation of blood in the uterine cavity.
• Postponed operations for the removal of the placenta and the remnants of the ovum.
• Complications after childbirth.
• Cesarean section performed.

Medical and diagnostic procedures carried out on the uterine cavity can cause disruption of the integrity of the endometrium. In this regard, probing, hysteroscopy, biopsy are dangerous. As a result of such procedures, lesions remain on the uterine lining, which are the entrance gate for infection.

If a woman is aborted or scraped, then the endometrium is cleaned off completely. After that, the uterus is a large bleeding wound surface. Any infection can easily penetrate into its basal layer.

Causes of endometritis in the postpartum period

A woman after giving birth to a child may develop endometritis. It occurs in 5% of all women in labor. If a cesarean section was performed, then the likelihood of developing inflammation increases to 30%.

The causes of endometritis in the postpartum period:

• Hormonal changes in the body.
• Weak immune system.
• Infection with viruses, bacteria, fungi or parasites.

The correct functioning of the nervous, endocrine and immune systems of a woman is of no small importance. If they fail, then the disease will have a severe course.

The reasons for the development of chronic endometritis

The chronic form of the disease develops when an acute infection has not been fully treated.

The following factors can provoke the development of the disease:

• Sex during menstrual bleeding.
• Injury to the uterus or cervix.
• Stress.
• Lack of vitamins in the body.
• Chronic diseases that negatively affect the state of immunity.
• Errors in intimate hygiene.
• Chronic diseases of the genital organs.

If an intrauterine device was installed in a woman, then this can lead to the development of endometritis. It is easier for infectious agents to climb into the uterus along the threads of this device. Less often, microbes enter the uterine cavity during the installation of the spiral. This happens when the antiseptic rules of the procedure are not followed. The longer a woman uses the coil, the higher the likelihood of chronic endometritis.

Doctors indicate that endometritis develops in 80% of cases in women of childbearing age who use spirals or often have abortions.

Other causes of endometritis

Other causes of endometritis include:

• Injuries received during childbirth with ruptures of the cervix or vagina. Bacteria easily penetrate into the uterus through the existing lesions and begin to multiply there.
• Chemical damage to the endometrium of the uterus.
• Frequent douching.
• Using contraceptives that contain chemicals and are inserted into the vagina. Spermicides disrupt its natural microflora.
• Long-term wearing of tampons. In this case, bacteria begin to multiply actively, which leads to inflammation.

Sometimes endometritis is limited to the uterus, and sometimes it spreads beyond it. It must be understood that for a long time the inflammation will not be concentrated in the superficial uterine layer. The infection will surely penetrate deeper if you do not get rid of it in time. Therefore, endometritis leads to infertility. The more the uterus is damaged, the less likely a woman is to become pregnant.

Acute endometritis requires immediate treatment. This will avoid the spread of infection and serious complications.

Endometritis symptoms

The symptoms of endometritis develop quickly, 3 days after the defeat of the uterus by pathogenic flora. The more massive the focus of inflammation, the more intense the signs of the disease.

Common symptoms

Once in the uterine cavity, bacteria or other microorganisms cause inflammation. First, it is localized in the surface layer of the organ. If a small area of the epithelium is affected, then the symptoms of endometritis will be mild. Sometimes a woman decides to heal herself. After taking the drugs, the symptoms of the disease disappear. The patient thinks that she has recovered. In fact, the disease simply subsided. If at this stage you do not start competent therapy, then the endometritis will turn into a chronic form.

Changes that occur to the uterus:

• The blood vessels feeding the organ dilate.
• The endometrium becomes thick.
• A purulent plaque appears on the mucous membranes of the organ. This leads to the fact that the cells of the organ begin to die off.
• The uterus has many glands. Due to the disease, they become pinched and begin to produce an inflammatory exudate. As a result, a woman's vaginal discharge increases dramatically.

In some patients, symptoms of the disease have a latent course, while in others, inflammation develops acutely. However, this process cannot remain unnoticed.

Patients present the following complaints to the doctor:

• Mucus and pus are secreted from the vagina.
• The discharge gives off an unpleasant odor. It occurs when Escherichia coli becomes the cause of the inflammation.
• Blood is visible in the discharge. This symptom indicates that there is a rejection of the endometrium of the uterus.
• The lower abdomen hurts. The pain can be mild or intense. It often radiates to the groin, tailbone, and intestines.

When the doctor begins to palpate the uterus, the patient indicates an increase in painful sensations. The pain will be more intense, the stronger the inflammation.

When inflammation develops due to the ingress of specific flora into the uterus, pus will be visible in the vaginal discharge. The mucous layer lining the organ becomes loose, and the lower layer of the uterus loses its natural defenses. This makes it easier for bacteria to penetrate the muscle layer of the uterus. In this case, the course of the disease is complicated.

Symptoms of acute endometritis

Acute endometritis manifests itself on the 4th day from the ingress of pathogenic flora into the uterine cavity.

The following symptoms will indicate the onset of the inflammatory process:

• The temperature rises to high levels. Sometimes it reaches 40 ° C.
• A sharp deterioration in health.
• Severe pain in the lower abdomen, which radiates to the intestines, groin, sacrum.

When the myometrium is involved in the inflammatory process, the patient cannot say with certainty exactly where her stomach hurts.

In addition to high body temperature, patients experience symptoms such as:

• Headaches.
• Nausea, which may end with vomiting.
• Increased weakness.
• Increased heart rate.

Pus and mucus are visible in the vaginal discharge. Streaks of blood are sometimes noticeable. They appear due to the fact that the inner layer of the uterus does not have time to recover, and the defects on it bleed.

The menstrual cycle is disrupted. Women complain of prolonged bleeding.

If endometritis develops after an abortion and particles of the ovum remain in the uterine cavity, then it will not be able to contract normally. This leads to the fact that the woman develops massive bleeding. Bloody clots are visible in the discharge.

The acute stage of the disease lasts no more than 10 days. If the treatment was selected correctly, then the woman recovers. When there is no therapy, the symptoms of endometritis also gradually fade away, but this does not mean that the disease goes away. It just transforms into a chronic form and will remind of itself from time to time.

Chronic endometritis symptoms

Chronic endometritis has a sluggish course. In this case, the mucous layer of the uterus is gradually destroyed and replaced by connective tissue. This leads to the fact that the uterus loses its natural functions.

Symptoms of the chronic form of endometritis:

• Irregular menstruation. In this case, the work of the ovaries will not be disrupted.
• Pain in the lower abdomen. It is not intense, but it bothers the woman for a long time.
• Changes in the structure of the endometrium with the formation of deep lesions on it.
• The menstrual cycle lengthens and exceeds 7 days. Menses become profuse.
• A woman cannot get pregnant.

In this case, the patient complains of a discharge that has a cloudy consistency. The chronic form of the disease is difficult to treat and causes the development of serious health problems.

Chronic endometritis leads to the fact that in 60.4% of cases, a woman becomes infertile. At the same time, in 37% of patients, attempts at IVF and embryo transfer are not successful.

Endometritis symptoms after childbirth

If the disease develops after childbirth, then the woman will experience symptoms such as:

• Immediately after giving birth, a woman develops vaginal discharge, which has an unpleasant odor. Their number is increasing dramatically.
• The body temperature rises, it can reach 39 ° C. This happens on the second day after the birth of the child.
• The woman begins to worry about severe pain in the lower abdomen.
• The patient's state of health worsens, there is no appetite, severe chills and headaches appear.
• The pulse quickens.
• ESR increases greatly.

During the examination, the doctor discovers signs of inflammation such as:

• The uterus contracts weakly.
• A woman complains of pain when the doctor palpates the organ.
• The discharge is brown. They may contain impurities of pus.

In some women, endometritis has an erased shape. Symptoms are blurred and difficult to identify. Inflammation develops 3-4 days after childbirth, and sometimes a few days later. In this case, the body temperature will not exceed 38 ° C, there is no chill, in the blood test the level of leukocytes noticeably increases. A small amount of blood may be present in the discharge, and it has an unpleasant odor. The erased form is dangerous because it is diagnosed late. In this case, the infection spreads with the blood flow throughout the body and the patient develops sepsis.

Such symptoms require urgent treatment.

Endometritis symptoms after cesarean section

After a cesarean section, a severe form of the disease often develops. The infection can be brought in during the first incision. In this case, the seam will not tighten, the wound on the uterus will not heal.

Recovery is complicated by the fact that the uterus loses its ability to contract normally. Exudate begins to accumulate in it. The symptoms of inflammation may appear 1-5 days after surgery. At this time, the woman is in the hospital, so doctors can provide her with adequate assistance to the situation.

Other signs of endometritis that develops after a cesarean section include:

• Increase in body temperature to high levels.
• Chills.
• Headaches.
• Nausea.
• Pain in the pubic area.
• Increased heart rate.

Features of vaginal discharge with endometritis against the background of a cesarean section:

• The discharge has an unpleasant odor, it is not transparent, watery. They may contain pus.
• A brown liquid is released from the genitals. Its volumes are increasing all the time.
• The seam becomes swollen.
• The woman has increased bloating, constipation may develop.
• Painful urination.
• Air accumulates in the seam area, and the scar will be deformed.
• The muscles of the uterus contract weakly.
• During palpation of the uterus, the woman complains of pain.
• The uterus is greatly dilated.
• In the blood, ESR and leukocyte levels increase.

Sometimes the symptoms of endometritis after a cesarean section develop several weeks after the operation. Therefore, after being discharged from the hospital, a woman should carefully monitor her well-being. If signs of inflammation are found, you should immediately consult a doctor.

Endometritis is dangerous with complications, so its self-treatment is unacceptable. This is especially true in the case when the disease develops after a cesarean section. If you do not consult a doctor in time, the disease will lead to infertility with a high degree of probability.

Endometritis diagnostics

If a woman discovers signs of endometritis, she needs to consult a gynecologist. The doctor will examine the patient in a chair, assess the nature of the discharge, and take a swab. He will be sent for cytology bacteriological examination. Sometimes PCR is required. This allows you to identify in such microorganisms as: chlamydia, ureaplasma, mycoplasma. For the study, you will need to donate blood from a vein. Another way to diagnose endometriosis is ultrasound.

During the examination on the gynecological chair, the doctor will be able to notice such signs of the disease as:

• Puffiness of the uterus, its inelasticity and large size.
• Touching an organ is painful.
• Pain when trying to move the cervix indicates inflammation of the peritoneum.

In the clinical analysis of blood, there will be a noticeable increase in ESR and a shift in the leukocyte formula to the left.

Ultrasound

You can suspect endometritis in a woman during an ultrasound scan.

The specialist will be able to notice such signs as:

• The uterus will be larger than normal.
• The endometrium thickens.
• Adhesions are visible in the uterus.

Ultrasound does not give a complete clinical picture of the disease. With its help, it will not be possible to determine the severity of the pathology. A biopsy is needed to get more information. However, this study is prescribed only for severe disease. In this case, a small piece of the mucous layer of the uterus is taken from the patient.

Differential diagnosis

Symptoms characteristic of endometritis can develop with other gynecological diseases.

Therefore, it is important to carry out differential diagnostics with such pathologies as:

• Parametritis that develops after childbirth.
• Thrombophlebitis of the pelvic veins.
• Metrothrombophlebitis.
• Pelvioperitonitis.
• Ectopic pregnancy.
• Acute appendicitis.
• Functional pain in the pelvic area.

Diagnostics of the acute form

Diagnostics begins with taking anamnesis, after which the doctor proceeds to a gynecological examination, palpates the uterus. The doctor then directs the patient to donate blood. She will need to undergo ultrasound and diagnostic laparoscopy. If the diagnosis cannot be made, a biopsy of the endometrium of the uterus is performed.

Diagnostics of the chronic form

During the diagnosis, you need to find out the following points:

• Clarify whether the woman has had an ectopic surgery.
• Find out if the woman has an ectopic spiral.
• Whether the patient suffered miscarriages.
• Whether she had previously suffered from acute endometritis.
• Does she have other diseases that can lead to infertility?

Then a smear is taken from the woman for examination. It is possible to perform scraping of the uterine mucosa with its further histological study. The patient is referred for ultrasound, hysteroscopy and biopsy. The main advantage of hysteroscopy is that this method is highly informative, but it is traumatic and equates to surgical intervention.

A comprehensive study of the mucous layer of the uterus is called immunohistochemical diagnostics. In the course of its conduct, a biopsy, aspirate and scrapings are studied, which are taken from a woman. This will allow for the most accurate diagnosis.

Diagnostics after childbirth

To make a diagnosis, you will need to take blood and urine for analysis, perform a LHC culture of a smear. Sometimes a CT or MRI is required. These studies are prescribed when there is a suspicion of pelvic thrombophlebitis or abscess.

Postpartum endometriosis is accompanied by an increase in body temperature. A similar situation is observed with atelectasis, stagnation of breast milk and infections of the genitourinary organs.

Endometritis treatment

Endometritis treatment is complex. It is based on the prescription of antibiotics, antioxidants and immunomodulators.

Acute treatment

If a woman is diagnosed with acute endometritis, then she should be hospitalized. She is shown adherence to bed rest. She should eat right and drink enough water.

The main directions of therapy:

• The appointment of antibiotics, which are aimed at destroying the causative agents of inflammation. For this purpose, drugs such as Ceftriaxone, Ceftazidime, etc. are used. In severe cases, several antibacterial agents are prescribed at once. If the cause of inflammation is anaerobic bacteria, then the patient is prescribed Metronidazole.
• In order to prevent the development of complications caused by taking antibacterial drugs, antifungal agents and probiotics are prescribed to a woman.
• To remove intoxication from the body, the introduction of protein and salt solutions, antihistamines is shown.
• Immunomodulators and vitamin and mineral complexes are designed to increase the body's own defenses.
• Anti-inflammatories are prescribed to lower body temperature.
• When the acute stage of the disease is over, the woman is prescribed physiotherapy.

In acute endometritis that has arisen after childbirth, antibacterial drugs from the group of cephalosporins or aminoglycosides are prescribed. The average course of treatment is 5-10 days. The drugs can be administered intravenously, but sometimes injections are placed directly into the uterine cavity. For quality treatment, it is important to establish the causative agent of the inflammatory process. This will allow targeted therapy. While the results are unknown, the patient is prescribed broad-spectrum antibiotics.

To alleviate the condition of a woman, it is necessary to prescribe antipyretic drugs, antimycotics, antihistamines to her. To increase the body's own defenses, immunomodulators and vitamins are prescribed.

Oral contraceptives are used to speed up the restoration of uterine tissue, and also prepare the body for conception.

Treatment of the chronic form

To cope with the chronic form of the disease, the patient is prescribed antibiotics, immunostimulants, and strengthening drugs. She is also shown physiotherapy.

To destroy microbes and restore their own microflora, they use drugs such as:

• Antibiotics: Ofloxin, Doxycycline.
• Hormonal drugs: Urozhestan.
• Metabolic agents: Tocopherol, Riboxin, Ascorbic acid, Actovegin.
• Hormonal drugs can help stop uterine bleeding.

Physiotherapy treatment involves such procedures as:

• Electrophoresis.
• Ultrasound treatment.
• Mud treatment.
• Treatment with mineral waters.

Therapy is aimed at arresting the inflammatory reaction, improving blood microcirculation, and increasing immunity.

To assess the effectiveness of the therapy, doctors are guided by criteria such as:

• The rate of regeneration of the epithelium.
• Relief of symptoms of inflammation.
• Restoration of fertility, resumption of menstruation, its regularity.

If menstruation cannot be restored, then the woman's chance of conceiving a child is extremely low.

Drug therapy

Antibiotics form the basis of therapy. They destroy the pathogenic flora, thereby neutralizing the inflammatory process.

Antibiotics are indicated for both oral administration and topical treatment. Ancillary drugs can help stop the symptoms of endometritis.

Inside take drugs such as:

• Spazmalgon and No-shpu. These remedies can help reduce pain.
• Metronidazole, Ofloxin, Doxycycline. These are antibacterial agents that destroy pathogenic flora.
• Nystatin, Fucis. These are antifungal drugs that help prevent the growth of fungal flora while undergoing antibiotic therapy.
• Ibuprofen, Aspirin, Paracetamol. These drugs help to lower body temperature.
• Cetrin, Eden. Taking antihistamines makes it possible to reduce tissue swelling.

For local therapy, drugs in the form of suppositories and ointments are used. They may contain an antiseptic, antimycotic and hormonal component.

These drugs include:

• Hexicon with chlorhexidine in candles. The drug is indicated for endometritis caused by viruses, fungi and bacteria, including gardnerella, chlamydia, Trichomonas. Geksikon has a pronounced antiseptic effect.
• Terzhinan in candles. This drug contains an antibiotic, an antifungal component and a glucocorticosteroid. Suppositories are effective for endometritis provoked by Staphylococcus aureus, fungi of the genus Candida, gram-positive bacterial flora. The course of treatment should last at least 10 days.
• Longidaza. This remedy is indicated for adhesions in the uterus. It contains mannitol and hyaluronic acid. These components help to reduce edema, resorption of connective tissue cords.
• Candles Polygynax. They destroy bacteria and fungi, but do not disturb the vagina's own microflora.
• Ginalgin candles. The drug fights against fungi and bacteria. It is prescribed for chronic and acute endometritis.
• Klion- D in suppositories. The drug contains an antimycotic and antifungal component.
• Iodine oxide in candles allows you to cope with endometritis, provoked by bacteria and fungi.

It is impossible to postpone the treatment of endometritis, since even the chronic form of the disease becomes the cause of infertility.

Treatment of a purulent form

Purulent endometritis requires urgent hospitalization of a woman. The patient is prescribed injections directly into the uterine cavity. Often, purulent endometritis occurs after childbirth, abortion, or caesarean section.

At the initial stages of the development of the disease, only the surface layer of the uterus becomes inflamed. If there is no treatment, then her muscle layer will be affected, which greatly complicates the therapy. Sometimes surgery may be required.

The main directions of therapy for purulent endometritis:

• Intravenous administration of a broad-spectrum antibiotic. Injection into the uterus.
• Local therapy with pills and suppositories.
• Intravenous administration of solutions to remove intoxication from the body.
• Oral intake of vitamins and immunomodulators.

Endometritis surgery

Often with purulent endometritis, surgical intervention is required, since pus blocks the cervical canal of the uterus. This leads to the fact that blood, mucus and pus remain in her cavity. To free the organ, you need to remove the plug.

For this purpose, such methods of surgical intervention are used as:

• Hysteroscopy.
• Probing.
• Dilation of the cervix.

Active emptying of the uterus is used if endometritis develops after childbirth or abortion and particles of the ovum remain inside. After emptying, the uterus is washed with antiseptic solutions.

If there is a lot of pus, the inflammation is severe and cannot be eliminated, the uterus is removed completely.

Treatment of purulent endometritis is carried out on an emergency basis. If the woman is not provided with immediate assistance, it will lead to serious consequences. The patient can lose not only the uterus, but also life.

Treatment of endometritis that develops after childbirth

If a woman develops postpartum endometritis, then hospitalization is indicated for the woman. The basis of therapy is antibacterial drugs. Be sure to prescribe drugs aimed at increasing immunity. In order for the normal outflow of exudate from the uterus to take place, antispasmodics are required.

Medicines for the treatment of postpartum endometritis:

• Cefuroxime.
• Ceftriaxone.
• Ofloxacin.
• Cefotaxime.
• Metronidazole in combination with Lincomycin.

Antibiotic treatment requires not breastfeeding. A woman should remember that after the treatment of endometritis, she will need to refrain from intimacy for a month.

If placenta particles remain in the uterine cavity, then surgery is required. In this case, vacuum aspiration, hysteroscopy and uterine lavage with antiseptics are used. Furacilin and Dioxidin are used as disinfecting solutions. When rinsing, all the pathological contents come out, it ceases to be absorbed into the blood, so the woman's well-being improves. After natural childbirth, washing is performed not earlier than 4-5 days, and after cesarean section - on 6-7 days.

Physiotherapy, which are indicated for women with endometritis after childbirth:

• Treatment with currents along Nemec.
• Treatment with low frequency currents.
• Reflexology.

It is imperative to treat endometritis that develops after childbirth, since this is a serious pathology that poses a threat to life.

Prevention of endometritis

To prevent the development of endometritis, the following recommendations must be observed:

• Compliance with the rules of hygiene. A woman should wash herself every day.
• Use of condoms during intimacy. This allows not only to protect against infection, but also to prevent unwanted pregnancy.
• Timely treatment of sexually transmitted diseases. Therapy should be carried out under medical supervision.
• Examination and testing before any intervention in the gynecological field. If a pathogenic flora is found, then first you need to get rid of it, only then proceed to the operation.
• Preventive course of antibiotics after abortion and diagnostic procedures associated with the risk of infection. The drugs are most often taken once.
• Planned visit to the gynecologist. All women must be examined by a gynecologist once every six months, undergo tests, and perform an ultrasound scan. This will allow you to identify endometritis in time and prescribe treatment.
• Control over the genitals when setting the spiral. Endometritis often develops in the first year after the insertion of the intrauterine device. Therefore, if unusual symptoms appear, you need to visit a doctor and get tested. Long-term use of an intrauterine device is no less dangerous in terms of the development of endometritis.

To prevent the development of endometritis in the postpartum period, you should adhere to such recommendations as:

• Take antibiotics. Women in labor who have undergone a cesarean section are often prescribed antibacterial drugs, a course of 5-7 days. This will prevent the development of inflammation of the uterus and prevent endometritis.
• Ultrasound examination. The study is indicated for women who have undergone difficult childbirth or cesarean section. During the procedure, it is possible to visualize the blood clots remaining in the uterine cavity, elements of the placenta, etc. If they are detected, the doctor will prescribe the woman procedures that prevent the development of inflammation (washing the uterus, scraping, taking antibiotics, etc.).

In order to prevent the development of chronic endometritis, it is necessary to qualitatively treat the acute form of inflammation. The main treatment is antibiotic therapy. A woman should remember that chronic endometritis leads to the development of infertility, which is difficult to correct.

Is pregnancy possible after endometritis?

An integrated approach to the treatment of chronic endometritis in 50% of cases leads to the fact that women manage to become pregnant and bear a healthy child.

It is possible to become pregnant after endometritis if the disease is treated with high quality. Absolute infertility is observed only after a severe form of the disease, when the woman's uterus is removed. There are many cases when patients who underwent purulent endometritis became happy mothers.

In order to increase the chances of a successful conception, it is necessary to consult a doctor at the first signs of uterine inflammation.

You can reduce the threat of miscarriage if you follow the recommendations of experts:

• Even at the stage of planning pregnancy, you need to treat the disease. This applies not only to the acute, but also to the chronic form of endometritis.
• After the onset of pregnancy, you need to go to an appointment with a gynecologist. A woman should visit a doctor throughout the entire period of carrying a baby.
• Chronic endometritis is often asymptomatic. It is possible to identify it only with the help of analyzes. Therefore, it sometimes happens that a woman finds out about her diagnosis only after conception. In fact, chronic endometritis allows you to become pregnant, although it significantly reduces the risks of becoming a mother. Moreover, the likelihood of miscarriage and other complications increases. Therefore, it is not uncommon for pregnant women with endometriosis to be hospitalized. This allows you to maintain the health of the expectant mother and child.
• During pregnancy, you must take vitamins that your doctor recommends. It is important to maintain moderate physical activity and avoid stress.
• Endometritis therapy is carried out in the 1st trimester of pregnancy. The doctor selects the safest antibacterial drugs for the woman. If the infection is left untreated, more harm will be done to the fetus than from drugs. In parallel, the pregnant woman will have to take eubiotics, antiplatelet agents, hormones that increase the level of estrogen in the blood.
• During pregnancy, physiotherapeutic techniques can be prescribed, including: acupuncture, plasmapheresis, leech therapy, etc.
• If necessary, the woman is artificially compensated for the hormone deficiency.

Against the background of endometritis, the likelihood of miscarriage increases. This most often happens at 5-6 weeks of pregnancy. Therefore, you need to strictly follow the doctor's prescriptions, take medications, and minimize physical activity. These activities will save the child.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.