One of the causes of female infertility is acute endometritis. The causes of this disease are varied, but most often it is the result of a gynecological injury. The progression of the pathological process in the body is dangerous by the development of complications. That is why it is important to be able to recognize the disease in the early stages.
What is endometritis?
Endometrium is a functional lining of the uterus that changes its structure during the menstrual cycle. Every month, it grows and matures anew, preparing for the attachment of a previously fertilized egg. If pregnancy does not occur, the functional membrane is rejected. Normally, the uterine cavity is reliably protected from the penetration of pathogenic flora. But under certain conditions, the infection can easily enter the reproductive organ, provoking an inflammatory reaction - endometritis. This disease requires immediate treatment. Lack of timely therapy can lead to further spread of the infection.
Acute andchronic endometritis. Each form of the disease has a characteristic clinical picture and requires specific treatment. In more detail, this article will talk about acute endometritis.
Description of the disease
Acute endometritis refers to a primary inflammatory process in the inner layer of the uterus. Its development is usually facilitated by various gynecological manipulations. The accumulation of blood clots, incomplete removal of the placenta or the remains of the ovum - all these factors create favorable conditions for the development of the infectious process.
Acute endometritis is manifested by severe pain in the lower abdomen, vaginal discharge with an unpleasant odor. Some people have a fever, discomfort when urinating. A particularly severe course of the disease is observed in patients who use intrauterine devices. The first symptoms of the disease are the reason for an immediate visit to the doctor. With the right therapy, treatment ends with a complete recovery.
Main causes of illness
Acute endometritis develops exclusively in the functional layer of the uterus. This happens due to damage to its structures. As a result, pathogenic flora can freely penetrate into the depths of the organ. Mechanical damage to the inner lining of the uterus itself can be caused by:
- curettage after an abortion;
- sloppy douching;
- Introduction of the IUD;
- probing the uterine cavity;
- Fallopian tube exam.
Endometritis refers tocategories of polyetiological diseases. Its development is facilitated by a whole group of pathogens. Sometimes only one of its representatives prevails. The most common causative agents of the disease are the following: group B streptococci, E. coli, chlamydia, Proteus, mycoplasma and Klebsiella.
It should be noted that in the body of a he althy woman, damage to the uterine mucosa rarely provokes the development of serious complications. For the occurrence of the inflammatory process, a certain trigger mechanism is required. For example, reduced immunity or lack of basic personal hygiene. As a result of the simultaneous interaction of these factors (damage + bacterium + trigger mechanism), the disease develops with all its symptoms.
First manifestations of pathology
Acute endometritis is characterized by a pronounced clinical picture. The first signs of the disease usually appear on the third day after infection. Among them are the following:
- Rise in temperature. A similar reaction of the body often accompanies acute infectious processes.
- Drawing pains in the lower abdomen. They can radiate to the sacrum or perineum. The inflammatory process in the body contributes to the active formation of biologically active substances, which cause pain.
- Vaginal discharge. The nature of the secret depends on the causative agents of the disease. For example, with a viral infection, acute catarrhal endometritis develops. Its typical manifestation isserous exudate. With a bacterial infection, pus is found in the excreted secret. Doctors explain its appearance by the presence of a large number of leukocytes, which are actively fighting pathogenic flora. However, most often the disease is accompanied by serous-purulent (mixed) discharge.
- Uterine bleeding. This symptom occurs due to damage to the basal layer of the endometrium.
The inflammatory process that accompanies the disease tends to spread rapidly to neighboring organs. Therefore, treatment should be started immediately.
Classification of acute endometritis
There are two forms of this disease: catarrhal and purulent. Each of them is characterized by a specific clinical picture.
Acute purulent endometritis develops as a result of an abortion or after childbirth. In rare cases, the disease is preceded by the decay of a malignant tumor. It is characterized by the accumulation of purulent secretion in the uterus, which makes it possible for infectious agents to freely penetrate into its cavity. Purulent endometritis is manifested by fever and pain in the lower abdomen.
In the catarrhal form, there is a constant discharge of serous exudate from the vagina. However, patients rarely complain of abdominal pain or fever. The disease is usually the cause of infertility. However, timely treatment avoids this pathology.
Separately, acute postpartum purulent-catarrhal endometritis should be considered. IN 20In % of cases, the disease is diagnosed after a caesarean section, and in 5% it is the result of spontaneous childbirth. Its first symptom is severe pain in the lower abdomen that does not go away with time. Also, women complain of high fever, chills, the appearance of uncharacteristic vaginal discharge with impurities of pus.
Diagnostic Methods
At the first consultation with a gynecologist, it is important to tell about all the disturbing symptoms, surgeries, cases of abortion. If endometritis is suspected, an examination is performed on a gynecological chair with mandatory palpation. During the diagnosis, the specialist pays special attention to the size of the uterus. It should not be enlarged and painfully responsive to touch.
Otherwise, a more detailed examination will be required. It implies the taking of smears and material for sowing in order to determine the type of pathogen, its reaction to drugs. Biochemical and clinical blood tests may also be required. Detection of leukocytosis and accelerated ESR usually indicate acute endometritis.
Another informative diagnostic method is ultrasound. Identification during the study of blood clots and pus in the uterus, thickening of its walls, changes in tissue echogenicity allows confirming the preliminary diagnosis. Often inflammation extends beyond the organ, reaching the ovaries and fallopian tubes. The spread of the pathological process can also be traced using ultrasound.
Drug therapy
Treatment of the disease is carried out permanently, as there is a risk of developing septic complications. The patient is required to have bed rest. She needs physical and psychological rest.
What drugs are prescribed for the diagnosis of "acute endometritis"? Treatment involves taking antibiotics. Even at the diagnostic stage, the doctor conducts a bacteriological analysis of the smear to determine the type of causative agent of the disease and its sensitivity to certain drugs. Results can be obtained no earlier than a week later. Therefore, at the initial stage of treatment, the patient is prescribed broad-spectrum antibiotics. The following medicines are characterized by the greatest efficiency: "Ampicillin", "Amoxicillin", "Gentamicin", "Lincomycin".
With a mixed microbial flora, a combination of several drugs is recommended. Due to the frequent addition of anaerobic flora to the pathological process, the treatment regimen is supplemented with Metronidazole. To eliminate the consequences of intoxication of the body, intravenous administration of physiological and protein solutions is indicated. Also, the treatment regimen usually includes immunomodulatory, antifungal and antihistamines. After the acute phase of the disease is removed, physiotherapeutic procedures and hirudotherapy are prescribed.
Treatment with folk remedies
Recently, to combat many ailments, patients prefer to use the recipes of folk healers. Endometritis is considered severea disease that, if ignored, can lead to serious he alth problems. Therefore, a qualified doctor should deal with the treatment of the pathological process. To obtain a stable therapeutic effect, the prescription of certain medications is required.
After pregnancy, doctors often diagnose acute purulent catarrhal endometritis. Even in the 17th century, this disease was already known. Moreover, it was considered the scourge of all maternity hospitals. The disease, which gradually turned into sepsis, claimed the life of every second newly-made mother. This example once again proves that you should not self-medicate.
Possible Complications
Lack of proper treatment of the disease can lead to the development of complications. Among them, the most common is the further spread of the infectious process to neighboring organs. As a result, sooner or later, blood poisoning occurs - sepsis.
Untreated endometritis in a timely manner also contributes to the development of the following conditions:
- chronization of the pathological process;
- pyometra (accumulation of pus in the uterus);
- salpingitis and oophoritis (inflammation of the fallopian tubes, appendages).
Late complications of the disease include menstrual irregularities and infertility. That is why it is important to seek qualified help at the first symptoms of the disease. Adequate treatment plays a significant role in preventing severe complications.
