Endometritis is an inflammatory disease of the endometrium, namely, the inner layer of the uterine mucosa. Often occurs with inflammation of the muscle layer - myometritis. During the menstrual cycle, the endometrium changes its structure, re-grows after each rejection in order to prepare the ground for attachment of the fertilized egg.
Normally, the uterine cavity is reliably protected from infection. However, under certain conditions, pathological microorganisms penetrate the uterine cavity with the subsequent development of acute endometritis.
Often such a violation leads to infertility, miscarriages, complications during pregnancy and childbirth. In addition, a deterioration in well-being can be observed in the postpartum period. To determine how to treat endometritis, you need to conduct a comprehensive diagnosis to make the correct diagnosis and determine the features of the course of the disease.
Disease feature
Before proceeding to the symptoms and treatment of endometritis, you need to understand exactly what this disease is. The uterus has 3 layers, the pathology develops in the inner layer, which also consists of 2 parts.
The superficial is rejected with every menstrual cycle, and a new one grows from the basal part. During pregnancy, the surface part atrophies, and the membranes involved in the development of the fetus form. Endometritis is characterized by inflammation of the basal layer, since the functional is constantly updated during menstruation. In the normal state, the cervical canal prevents the penetration of pathogens, and the mucosa is updated to prevent deep penetration into the layers of the uterus.
Inflammation develops as a result of damage to the mucosa, when there is a decrease in its protective functions, as well as a deterioration in immunity. The acute form often occurs after previously undergoing abortions, childbirth, as well as many other manipulations that are performed on the uterus. The chronic form is formed with untreated acute endometritis. Often, the inflammatory process goes to adjacent layers of the uterus. The disease itself is not very dangerous, however, if you do not notice the symptoms of endometritis in time, the treatment will take a long time, and dangerous complications can also develop.
Classification
Depending on the symptoms, endometritis in women can vary significantly, however, with the course of the chronic form, vivid signs are not observed. According to the existing classification, these types of diseases are distinguished:
- acute;
- subacute;
- chronic;
- exacerbation of chronic inflammation.
The acute course of the disease can be focal or diffuse in nature, and in the chronic form, hypertrophic, atrophic, as well as cystic type of inflammation can be observed. Symptoms and treatment of endometritis largely depend on determining the exact type of pathology, so the doctor should initially conduct a full range of diagnostics.
Causes of occurrence
Depending on the cause of the formation of inflammation, the symptoms and treatment of endometritis (pictured) can vary significantly. The main provoking factor is the defeat of the endometrial layers and the penetration of pathogens. For the development of the disease, the penetration of pathogens, as well as a decrease in protective mechanisms, is important. Infection can spread in several ways:
- from the cervix or vagina;
- lymphogenous method;
- hematogenous way.
Depending on the causative agents of the disease, it is divided into specific endometritis and non-specific. A specific type is associated with the multiplication of pathogens in the uterine cavity. The nonspecific appearance is due to the use of the intrauterine device, irradiations of the uterus, as well as a violation of the microflora, hormonal changes in the absence of pathogens.
Often at risk are patients who:
- have previously had an abortion or miscarriage;
- located in the period of the menstrual cycle;
- having traumatic injuries.
Endometritis can occur even with improper douching. Also at risk are women wearing an intrauterine device, suffering from chronic inflammation of the cervix, and also having candidiasis.
It is worth noting that violation of the rules for the use of tampons, which can also provoke the occurrence of toxic shock syndrome, is important. Another cause of endometriosis can be chronic stress, which significantly increases the risk of infection.
The main symptoms
By the nature of the course, an acute and chronic form of the disease is distinguished. Symptoms of endometritis in women with acute course appear already in the first week after childbirth, abortion and trauma to the uterine mucosa. Among the main signs of a pathology, one can distinguish the following:
- deterioration in overall health;
- drawing pains in the lower abdomen;
- temperature rise;
- discharge having an unpleasant odor;
- uterine bleeding.
The very first symptoms of endometritis treatment require immediate, which is why you need to immediately undergo a comprehensive diagnosis. Therapy is aimed at eliminating the infectious process and preventing the transition to the chronic stage.
The acute period lasts for about a week or a little longer. With timely treatment, you can achieve a good result.
Symptoms and treatment of chronic endometritis are somewhat different from the acute course. Among the main signs of such a violation are the following:
- irregular periods and their duration;
- increased soreness;
- change in the amount of discharge;
- bleeding from the genitals outside the menstrual period.
The severity of the pathological process is determined by the depth and duration of the developed changes in the structure of the endometrium.
Diagnostics
Before determining what to treat endometritis, it is necessary to carry out a comprehensive diagnosis, which includes:
- bacterial culture for the detection of pathogens;
- ultrasound scanning;
- hysteroscopy;
- morphological assessment;
- PCR diagnostics.
General clinical tests will determine the course of inflammation in the body of a woman. When conducting ultrasound diagnostics, the doctor can assess the presence of pathological changes in the uterus, as well as vascular disorders. During the diagnosis, it is possible to identify not only endometritis, but also other pathologies of the ovaries and uterus.
Treatment features
Depending on the symptoms, the treatment of uterine endometritis is selected strictly individually for each woman. With a primary infection, the disease can be cured simply enough, most importantly, to start antibiotic therapy in a timely manner. This will avoid the development of severe complications. Getting rid of the chronic form is much more difficult. In the presence of characteristic symptoms of uterine endometritis, treatment can only be prescribed by a doctor. It should include in the following types of therapy:
- antibacterial effect;
- drugs to normalize blood circulation in the uterus;
- anti-inflammatory and analgesics;
- normalization of the hormonal background;
- physiotherapy;
- ethnoscience;
- Spa treatment.
In the presence of acute symptoms of endometritis in women, treatment begins with the appointment of broad-spectrum antibiotics, as this will prevent the subsequent spread of the infectious process. With a low-symptom course of the disease and the risk of infertility, the whole range of therapeutic procedures should be used, which will prevent the occurrence of dangerous complications.
Depending on the existing symptoms of endometritis, treatment for women is carried out strictly individually; the desire to become pregnant and give birth to a child is necessarily taken into account.
Medications
In the presence of characteristic symptoms of endometritis, treatment is carried out in a hospital with the mandatory observance of physical and psychological calm, as well as compliance with the following regimes:
- bed;
- drinking;
- food;
- rest and sleep.
The basis of drug therapy is the appointment of drugs aimed at eliminating infection and provoking factors, which is why such drugs are prescribed:
- antibiotics - Amoxicillin, Metronidazole, Tinidazole;
- antifungal agents - "Flucostat", "Clotrimazole";
- antiviral - “Acyclovir”;
- preparations for the normalization of metabolism - Actovegin, Riboxin;
- antihistamines - Diphenhydramine, Tavegil, Suprastin;
- probiotics - "Bifitrilak", "Bifiform", "Lactusan";
- immunomodulators - Cycloferon, Likopid;
- painkillers - Nurofen, Analgin;
- vitamin complexes.
To eliminate the symptoms of endometritis, chronic treatment is carried out with the help of antimicrobial, hormonal, immunomodulating drugs. In addition, general strengthening procedures, as well as sanitary and spa therapy, need to be carried out.
Physiotherapy
After the acute symptoms subside (pictured), the treatment of endometritis in women is carried out using physiotherapeutic techniques. Physiotherapy can be effective in the acute and chronic stages of the disease. In a hospital, magnetotherapy and electrophoresis are most often used. When conducting the first, a magnetic field acts on the body, normalizes the reflex function of tissues and organs. Thanks to the use of such a technique, it is possible to eliminate pain, inflammation, increase immunity, and also accelerate metabolism.
Therapy with magnetic waves is carried out with a subacute or chronic stage of the course of the disease. Sessions last for 10-15 minutes, the course of therapy is indicated for 10-20 days. When performing such a procedure, a woman may experience dizziness and slight malaise, however, this is not at all dangerous.
For the electrophoresis procedure, a current is applied, which contributes to a more rapid penetration of drugs to the affected area. For the procedure, charged electrodes are used, which are located so that the uterus is between them. This technique allows you to eliminate inflammation and swelling in just a few days of regular use.
Physiotherapeutic treatment is indicated at any stage of the course of the disease. In the acute form, physiotherapy is required only at the recovery stage. Contraindications include the presence of tumors, pregnancy, as well as an exacerbation of the inflammatory process.
Folk remedies
To eliminate the symptoms of endometritis, folk remedies are used as adjunctive therapy. Various herbs are used to eliminate the symptoms of the disease, but they are not able to kill viruses and bacteria.
If symptoms of endometritis occur in women, treatment with alternative methods should be started immediately, since at later stages it is difficult to achieve the desired result. Sea buckthorn oil, which is used as a tampon, helps very well. The course of therapy lasts for 10-12 days. Sea buckthorn oil helps eliminate inflammation and promotes tissue healing.
Inside, you can take a decoction of fern leaves, as well as a mixture of honey, aloe and wine. Therapy must be carried out only comprehensively, as this will achieve a more positive result. In order to qualitatively eliminate the symptoms of endometritis, treatment with folk remedies can be carried out only after consultation with the treating doctor.
Surgical intervention
Surgery is required only if the pathology was provoked by the presence of an intrauterine device or by the remains of the ovum after a miscarriage or abortion. Surgical intervention is also indicated if after delivery in the uterine cavity there is a trace.
To clean the uterus, curettage is indicated, and then a course of saline solutions is prescribed to normalize the temperature.
The course of the disease during pregnancy and after childbirth
This disease poses a serious danger during the period of bearing a child. Timely diagnosis and treatment will save the baby's life, and otherwise, as the disease develops, the fetus may die.
The inner lining of the uterus ensures a normal state during pregnancy. Any changes negatively affect the development of the fetus and can provoke very serious consequences. Endometritis is very dangerous for infection to enter the uterine cavity. Prolonged infectious damage can provoke the destruction of placental defense, damage to the tissues and organs of the fetus.
This is fraught with improper tissue formation and the development of a more dangerous congenital disease - endometriosis. In addition, there is an emission of toxic substances that can change the course of pregnancy.
In order to avoid undesirable consequences and complications, women need to be examined before planning pregnancy. Among the main symptoms of endometritis, pain in the lower abdomen, fever, purulent discharge can be distinguished. That is why when the first signs occur, you need to contact a doctor who will conduct an examination and prescribe the appropriate therapy.
Postpartum endometritis is a fairly common disease and occurs as complications. Diagnose it by ultrasound. Among the main causes of such a violation can be identified as follows:
- prolonged labor period;
- large fruit and its incorrect location;
- preeclampsia;
- narrow pelvis;
- old-born women;
- early birth;
- premature detachment of the placenta;
- the presence of sexually transmitted diseases.
If symptoms of endometritis occur after delivery, treatment begins with an ultrasound diagnosis. Especially required is the examination of women at risk, which include previous abortions with chronic pyelonephritis and tonsillitis, as well as complications after delivery.
Possible complications
Lack of treatment or improperly selected therapy can lead to various problems and pathological conditions, in particular:
- spread of infection to the reproductive organs;
- the formation of ovarian cysts;
- uterine polyps, leiomyoma;
- miscarriage;
- infertility.
In order to prevent the development of dangerous complications, it is necessary to strictly comply with all the recommendations and instructions of the attending physician.
Prophylaxis
In order to avoid the development of endometritis, it is necessary to carry out preventive measures, which include timely treatment of inflammatory and infectious processes, sexually transmitted diseases. In addition, it is important to prevent abortion, to observe thorough hygiene of the genitals. It is important to regularly undergo gynecological examinations so that pathology can be detected in the initial stages.