One of the causes of female infertility is acute endometritis. The causes of this disease are diverse, but most often it is a consequence 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 in the early stages to be able to recognize the ailment.
What is endometritis?
The endometrium is the functional membrane of the uterus, which changes its structure during the menstrual cycle. Each month, it re-grows and matures, preparing to attach 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 get into the genital organ, provoking an inflammatory reaction - endometritis. This disease requires immediate treatment. Lack of timely therapy can lead to further spread of the infection.
By the nature of the course, acute and chronic endometritis is distinguished . Each form of the disease has a characteristic clinical picture and requires a certain treatment. In more detail in this article we will talk about acute endometritis.
Disease Description
Acute endometritis refers to the initially occurring inflammatory process in the inner layer of the uterus. Various gynecological manipulations usually contribute to its development. The accumulation of blood clots, the incomplete removal of the placenta or the remains of the fetal egg - 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 immediate medical attention. With the right treatment, treatment ends with a complete recovery.
The main causes of the disease
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. The mechanical damage to the inner lining of the uterus itself can be caused by:
- curettage after abortion ;
- sloppy douching;
- the introduction of the IUD;
- sounding the uterine cavity;
- examination of the fallopian tubes.
Endometritis belongs to the category of polyetiological diseases. Its development is facilitated by a whole group of pathogens. Sometimes only one representative prevails. The most common pathogens of the disease are considered to be: group B streptococci, Escherichia coli, chlamydia, protea, mycoplasma and Klebsiella.
It should be noted that in the body of a healthy woman, damage to the uterine mucosa alone rarely provokes the development of serious complications. For the occurrence of the inflammatory process, a certain trigger is required. For example, reduced immunity or lack of basic personal hygiene. As a result of the simultaneous interaction of these factors (damage + bacteria + trigger), the disease develops with all its symptoms.
The 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:
- Temperature rise. 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 is serous exudate. With a bacterial infection, pus is detected in the secreted secretion. Doctors explain its appearance by the presence of a large number of white blood cells, which are actively struggling with pathogenic flora. However, most often the disease is accompanied by serous-purulent (mixed) secretions.
- 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 abortion or after childbirth. In rare cases, the disease is preceded by the collapse of a malignant tumor. It is characterized by the accumulation of purulent secretion in the uterus, which allows infectious agents to freely penetrate into its cavity. Purulent endometritis is manifested by fever and pain in the lower abdomen.
With the catarrhal form, there is a constant discharge of serous exudate from the vagina. In this case, 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 20% of cases, the disease is diagnosed after cesarean section, and in 5% is the result of an independent birth. Its first symptom is severe pain in the lower abdomen, which does not go away with time. Also, women complain of high fever, chills, the appearance of uncharacteristic discharge from the vagina with impurities of pus.
Diagnostic Methods
At the first consultation with a gynecologist, it is important to talk about all the disturbing symptoms, previous operations, and cases of abortion. If you suspect endometritis, an examination is performed on a gynecological chair with mandatory palpation. During 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. The 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 echogenicity of tissues allows you to confirm a 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
The treatment of the disease is carried out inpatiently, since there is a risk of developing septic complications. The patient is required to show bed rest. She needs to provide physical and psychological peace.
What drugs are prescribed for the diagnosis of acute endometritis? Treatment involves taking antibiotics. Even at the stage of diagnosis, the doctor conducts a bacteriological analysis of the smear to determine the type of pathogen 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 most effective: Ampicillin, Amoxicillin, Gentamicin, Linkomycin.
With a mixed microbial flora, a combination of several drugs is recommended. Due to the frequent accession of anaerobic flora to the pathological process, the treatment regimen is supplemented with Metronidazole. To eliminate the effects of intoxication, intravenous administration of physiological and protein solutions is indicated. Also, immunomodulatory, antifungal and antihistamines are usually included in the treatment regimen. After removing the acute phase of the disease, physiotherapeutic procedures and hirudotherapy are prescribed.
Treatment with folk remedies
Recently, to combat many ailments, patients prefer to use recipes of folk doctors. Endometritis is considered a serious illness, ignoring which can lead to serious health problems. Therefore, a qualified doctor should deal with the treatment of the pathological process. To obtain a stable therapeutic effect, the appointment of certain medications is required.
After pregnancy, doctors often diagnose acute purulent-catarrhal endometritis. Even in the XVII 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 proves once again that self-medication is not worth it.
Possible complications
The lack of competent 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).
The late complications of the disease include menstrual irregularities, as well as infertility. That is why it is important at the first symptoms of an ailment to seek qualified help. Adequate treatment plays a significant role in preventing serious complications.