Endometritis is inflammation of the inner lining of the uterus (endometrium). Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. It is the most common cause of infection after childbirth. It is also part of spectrum of diseases that make up pelvic inflammatory disease.Endometritis is divided into acute and chronic forms. The acute form is usually from an infection that passes through the cervix as a result of an abortion, during menstruation, following childbirth, or as a result of douching or placement of an IUD. Risk factors for endometritis following delivery include Caesarean section and prolonged rupture of membranes. Chronic endometritis is more common after menopause. The diagnosis may be confirmed by endometrial biopsy. Ultrasound may be useful to verify that there is no retained tissue within the uterus.Treatment is usually with antibiotics. Recommendations for treatment of endometritis following delivery includes clindamycin with gentamicin. Testing for and treating gonorrhea and chlamydia in those at risk is also recommended. Chronic disease may be treated with doxycycline. Outcomes with treatment are generally good.Rates of endometritis are about 2% following vaginal delivery, 10% following scheduled C-section, and 30% with rupture of membranes before C-section if preventive antibiotics are not used. The term "endomyometritis" may be used when inflammation of the endometrium and the myometrium is present. The condition is also relatively common in other animals such as cows. Symptoms
Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. Types
Acute endometritis
Acute endometritis is characterized by infection.
Usage
When a woman takes COCP, the hormones in the pills prevent both ovulation and shedding of the endometrium (menstruation). Traditionally, COCPs are packaged with 21 active (hormone-containing) pills and 7 placebo pills. During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle. The placebo pills are not required for pregnancy protection, and with any monophasic COCP the placebo pills may be discarded, and the next pack of active pills may be started to prevent the withdrawal bleeding. With bi- and tri-phasic pills, skipping the placebo week results in a sudden change in hormone levels, which may cause irregular spotting or flow. (Monophasic pills offer the same dose of estrogen and progestogen whereas multiphasic pills have varying doses from day to day; see formulations for details.) Recently, several pharmaceutical companies have gained FDA approval to package COCPs for the intended use of reducing the frequency of or eliminating withdrawal bleeding. Clinical indications
Extended or continuous use of COCPs has been used for many years to treat endometriosis, dysmenorrhea, and menstruation-associated symptoms. Some studies have suggested that women who experience premenstrual-type symptoms during the placebo (hormone-free) week of traditionally packaged COCPs may experience significantly fewer symptoms when placed on extended cycle COCP regimens.More recently, personal preference to avoid menstruation has also become a common reason for use. Personal preference is the most common reason extended cycle or continuous use COCPs are prescribed to adolescents.