Endometritis: symptoms and treatment, causes

What it is? Endometrite is an inflammatory process in the mucosa and the muscular wall of the uterus.

This pathological process usually develops after any intra-uterine interventions.

Its danger lies in the fact that in the absence of timely treatment, it is possible to develop a uterine form of infertility and other complications that eventually become irreversible.

Classification of

What is this - endometritis by the nature of the course of the pathological process can be acute and chronic. In the latter case, it flows wavy, that is, the periods of remission and exacerbation alternate with each other.

According to the nature of cause-significant microorganisms, endometritis can be of two types:

1. 1) Specific - is most often associated with infection with pathogenic microorganisms( chlamydia, mycoplasmas, ureaplasmas, gonococci, trichomonads, herpes virus, etc.)
   
2. 2) Nonspecific,-pathogenic microflora( streptococci, staphylococcus, E. coli, proteus, pseudomonas).

Etiological classification implies the separation of endometritis into such species as:

1. 1) Bacterial
   
2. 2) Viral
   
3. 3) Fungal

Reasons for endometritis

Endometritis in women is almost always associated with infectious inflammation. In some cases, infection with pathogenic microorganisms, which always cause the development of an inflammatory reaction, and in others - the activation of opportunistic organisms that live in the vagina.

This is associated with a decrease in immunity, which may be due to the following factors:

• pregnancy( decreased activity of ongoing immune reactions)
  
• hypo- and avitaminosis
  
• presence of concomitant diseases
  
• diabetes
  
• congenital immunodeficiency
  
• administration of immunosuppressants, etc.

In addition, local predisposing factors are identified that significantly increase the risk of developing endometritis. These include various intrauterine interventions, namely:

• births
  
• intrauterine contraceptives introduction
  
• medical abortions
  
• diagnostic scraping of the uterine cavity
  
• removal of a birthing myomatous node
  
• drug( with pharmacological drugs) abortion
  
• spontaneous miscarriages.

Chronic endometritis, as a rule, represents untimely and inadequately treated acute inflammatory process in the uterine cavity. With its development, the role of the causative microorganism goes to the background.

The dominant links of the pathological process are the incorrect reaction of the immune system. As a result, this leads to additional damage to the organ.

Symptoms of endometritis

Manifestations of endometritis in women are determined by the severity of the pathological process.

Thus, acute endometritis has vivid clinical symptoms and a sudden onset of the disease. The main sign is considered to be the appearance of pains in the lower abdomen, which irradiate into the lumbar and sacral region, as well as into the perineum and groin.

In addition, the acute endometritis is also characterized by:

• fever, which can reach high values ​​depending on the reactivity of the female
  
• presence of abnormal discharge from the genital tract( often puffy), which often have an unpleasant odor
  
• slowing the processes of reverse development of the uterus after childbirth or curettageuterine cavity
  
• uterus becomes soft consistency or test
  
• during vaginal examination reveals tenderness when palpating the uterus
  
• in totalecclinic blood analysis marked an increased level of leukocytes, acceleration of ESR, shift of the leukocyte formula to the left side of the
  
• increases the leukocyte index of intoxication.

With chronic endometrium in the stage of remission, clinical manifestations are practically absent. The main manifestations are the development of complications( see below).

Symptoms of acute endometritis appear only at the stage of exacerbation. It in many ways resembles the manifestations of acute inflammation of the uterus.

Diagnosis of

In unclear clinical cases, the use of additional diagnostic tests is indicated:

1. 1) Ultrasonic examination of pelvic organs
   
2. 2) Hysteroscopic examination - examination of the uterine cavity using the endoscopic technique
   
3. 3) Bacteriological study with an assessment of the antibiotic susceptibility of the uterine cavitytime of sampling of material must be adhered to special rules so as not to pollute the culture with vaginal discharge).

Diagnostic search for chronic endometrium also includes an assessment of the immune status. This is necessary for the selection of adequate immunostimulating therapy.

Treatment of endometritis

Treatment of acute endometritis of the uterus and exacerbation of the chronic is carried out according to general principles. They are as follows:

1. 1) Compliance with bed rest for complete recovery of strengths
   
2. 2) Dosed cold application to the abdomen( low temperatures cause vasospasm that prevents further spread of the inflammatory process)
   
3. 3) Sufficient drinking volume or according to indications( severecondition of the patient) is prescribed infusion therapy
   
4. 4) Antibacterial therapy taking into account the sensitivity of the isolated microorganisms
   
5. 5) Use of non-steroidal anti-inflammatory drugs
   
6. 6) Desensitizing agents that reduce the severity of the body's allergic state
   
7. 7) Soothing drugs are prescribed only in the emotional lability of a woman
   
8. 8) Drugs that reduce the uterus
   
9. 9) Vitamin preparations that normalize the metabolism in the body.

In the stage of remission of chronic endometritis, application of physiotherapeutic procedures is indicated. Sanatorium-and-spa treatment, which allows to restore the normal structure of the uterus, also proved to be very good.


Otherwise, it will support inflammation. A similar situation occurs in endometritis after childbirth.

In this situation, if there are residues of the decidua, placental tissue, blood clots, they are recommended to be evacuated, since they are a good nutrient medium for microorganisms.

Complications of endometritis

The absence of timely diagnosis and treatment of endometritis in women can lead to complications.

They can be divided into two main groups - short-term( develop in the near future) and long-term( develop after a certain time).The first group includes the following:

• panmetritis - inflammation of all layers of the uterus
  
• salpingo-oophoritis - inflammation of the uterine appendages
  
• parametres - inflammation of the fiber surrounding the uterus
  
• peritonitis - inflammation of the peritoneum( pelvic hypertension - inflammation of the peritoneum covering the pelvic organs)
  
• abscess of the Douglas space - purulent inflammation in thebehind-the-field space
  
• thrombotic veins of the pelvic floor. Complications of the second group are:
  
  
  
  1. 1) Infertility form of infertility
     
  2. 2) Adhesive process in pelvic organs
     
  3. 3) Asherman's syndrome - the presence of adhesions in the uterine cavity
     
  4. 4) Syndrome of chronic pelvic pain is a pain syndrome in the lower abdomen that remainsfor 6 months or more.
  Given all of the above, it becomes clear that the diagnosis and treatment of endometritis should begin as early as possible. Therefore, when the first signs of the disease, similar to endometritis, it is necessary to seek medical help from a gynecologist.
  
  In conclusion, it should be noted that endometritis often develops in the postpartum period, after scraping the uterine cavity and against the background of intrauterine contraceptives.
  
  The severity of the clinical picture of this disease depends on the severity of the pathological process. However, to establish a definitive diagnosis, it is necessary to apply additional methods of investigation. The subsequent treatment should always be comprehensive, taking into account the cause that led to the development of this pathological process.
  
  

  
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