Endometritis is an inflammatory disease of the inner (mucous) membrane of the uterus (endometrium).
This shell is very important in the functioning of the female body, because its growth in the first phase of the menstrual cycle and rejection in the second are the basis of the menstruation process. Endometrium plays a leading role in regulating the development of the embryo in its early stages, in providing conditions for its attachment to the wall of the uterus. Therefore, any structural changes in it entail primarily violations of the process of menstruation and reproductive functions.
The main condition for the development of endometritis is getting into the uterus (ideally sterile) pathogenic microorganisms, which find there a favorable environment for growth and development. Most often this occurs after childbirth, abortion, scraping and other intrauterine manipulations, when the risk of pathogens is greatest.
Other factors provoking endometritis are:
- reduced immunity;
- the presence of chronic infections;
- non-compliance with the rules of intimate hygiene;
- sexual intercourse during menstruation;
- injury to the uterus and cervix;
- use of intrauterine device.
According to the clinical picture, there are two forms of the disease – acute and chronic.
Most often occurs after childbirth and abortion. Symptoms appear 3-4 days after infection in the uterus. In acute endometritis weakness, malaise, pain in the lower abdomen, increased heart rate, temperature rise to 38–38.5 ° C, increase and hardening of the uterus, its soreness during palpation is noted. The discharge is turbid, abundant, with a purulent odor. Uterine bleeding is possible. In severe cases, pyometra may develop (accumulation of pus in the uterus).
With incorrect or incomplete treatment, acute endometritis can become chronic.
It occurs as a result of sexually transmitted diseases, or against the background of acute endometritis. The chronic form may be latent and have no clinical manifestations – then the diagnosis is made on the basis of laboratory research data.
Among the most common symptoms of chronic forms of endometritis are menstrual disorders, discharge before and after menstruation, the appearance of light, scarce serous discharge, mild back pain.
In this form of the disease, endometrial structural changes associated with malnutrition of tissues or the formation of cysts are observed. Therefore, in women with chronic endometritis, infertility or miscarriage is often encountered, because a fertilized egg can not attach to the modified uterine membrane.
As a rule, endometritis is treated in the hospital and only under the supervision of a physician. Self-treatment can lead to further spread of the infection, cause infertility. In cases where the cause of endometritis are residues of the ovum after an unsuccessful abortion or parts of the placenta after birth, these elements are removed and the uterus is washed with aseptic solutions.
Since the main cause of the development of the disease is microbial infection, antibiotics are necessarily included in the treatment complex, in accordance with the sensitivity of the pathogen to them, or broad spectrum antibiotics.
Usually, various combinations of drugs are used, for example, metronidazole (metrogyl) intravenously and gentamicin intramuscularly. This helps to achieve greater efficiency in the case when the disease is caused by several types of microorganisms.
Successfully used in the treatment of severe forms of endometritis and third-generation cephalosporins: ceftazidime, ceftriaxone, cefoperazone, etc., as well as imipenem / cilastatin and meropenem, which have an ultra-wide spectrum of antimicrobial action. Due to their high efficacy and low toxicity, these drugs help replace several combinations of antibiotics. The duration of therapy is determined by the severity of the patient’s condition and continues until a complete victory over the causative agent of the disease.
In addition to antibacterial drugs, if necessary, prescribe a complex of other therapeutic measures: painkillers, antispasmodic and hemostatic drugs, intravenous drip infusion of solutions that accelerate the elimination of toxins from the body.
When treating endometritis it is very important to increase the body resistance. They prescribe vitamins, drugs that normalize cell metabolism, increase immunity – interferon preparations (Kipferon or Viferon), as well as injections of a normal human immunoglobulin.
One of the leading places in the complex therapy of endometritis belongs to procedures that promote the activation of blood circulation in the pelvic organs, stimulating their function. Apply magnetic therapy , pulsed ultrasound, electrophoresis with iodine and zinc, UHF heating, mud therapy, paraffin and ozocerite applications on the lower abdomen.
After a course of anti-inflammatory therapy, it is recommended to take oral contraceptives for several months (novinet, diane-35, zhanin). They have antioxidant and anti-inflammatory properties and help normalize the menstrual cycle. In addition, the woman avoids unwanted pregnancy, and hence abortion, which can lead to an exacerbation of the process.
In most cases, timely treatment leads to good results, thus avoiding complications of pregnancy and childbirth.
Prevention of endometritis in women with a high risk of developing the disease (for example, after cesarean section) involves taking antibacterial drugs.
Prevention after treatment is based on sterility during uterine procedures, childbirth, abortions, and sexual hygiene. Be sure to regularly monitor a gynecologist (preventive examinations at least twice a year) in order to promptly identify inflammatory infections. To avoid exacerbations of endometritis, it is important to strengthen the immune system.