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Endometritis

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Endometritis, Endomyometritis

  • See Also
  1. Postpartum Endometritis
  2. Endometritis Management
  • Causes
  1. Pelvic Inflammatory Disease
  2. Postpartum
    1. Chorioamnionitis
    2. Endometritis
      1. Early Postpartum (<48 hours) after C-Section
      2. Late Postpartum (48 hours - 6 weeks) after NSVD
  3. Uterine instrumentation
  4. Septic Abortion
  • Pathophysiology
  1. Bacterial Infection of the Uterus
    1. Bacteroides
    2. Group B Streptococcus
    3. Group A Streptococcus
    4. Enterobacteriaceae
    5. Chlamydia trachomatis
    6. M. hominis
  • Symptoms
  1. Lower abdominal cramps
  2. Foul Vaginal Discharge
  3. Nausea and Vomiting
  • Signs
  1. Fever
  2. Lower abdominal tenderness and Muscle spasm
  3. Cervical motion tenderness
  • Labs
  1. Complete Blood Count
    1. Leukocytosis
  2. Gram Stain and culture of cervical discharge
  3. Gonorrhea Culture
  4. Chlamydia swab
  • Management
  1. See Endometritis Management
  2. Inpatient (Indicated in most cases)
    1. Option 1
      1. Cefoxitin OR Timentin OR Imipenem OR Unasyn AND
      2. Doxycycline
    2. Option 2
      1. Clindamycin AND
      2. Ceftriaxone OR Cefotaxime OR Gentamycin
  3. Outpatient (Indicated for late Postpartum Endometritis)
    1. Non-lactating mother
      1. Doxycycline 100 mg q12h IV or PO for 14 days
    2. Lactating mother
      1. Doxycycline
        1. Pump and dispose of milk
      2. Clindamycin may be effective