Endometritis

October 18, 2012

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Endometritis   - A common disease among women, causing them to exhibit inflammation of the mucous membrane of the uterus . The development of endometriosis uterus due to the deterioration of the immune system, to which, in turn, maintain a permanent chronic stress , Disease, have fallen into a chronic form of intoxication. Very negative in this case, it affects the development of injury in the course of the disease delivery   and abortion uterus and cervix. Doctors say that women who during delivery process received a deep and extensive cervical tears, more often diagnosed with a chronic form of the disease. Doctors distinguish between acute and chronic endometritis.

When the disease is manifested?

Endometritis occurs in women under the influence of a number of states of the organism and external reasons. The disease often affects the body in different forms of female infertility After hormonal treatment of miscarriage or surgically, with urogenital infections, after the introduction into the cavity of the uterus of medical instruments for chronic diseases. Also endometritis often develops after suffering caesarean section , Prolonged and obstructed labor. The disease affects the uterus and if during childbirth a woman has a prolonged dry period, that is from the outpouring of water before the birth was more than 12 hours. The risk of disease increases in the case of multiple pregnancy, repeated delivery, polyhydramnios, as this greatly expands the womb and after birth reduces worse. Endometritis often develops as a consequence of severe third stage of labor, resulting in the uterus may remain fragments of membranes or the placenta. Another fact that influences the development of endometritis - the wrong approach to personal hygiene.

The acute form of endometritis

Initially, inflammation occurs in the uterus as a consequence of falling into its cavity infection of the cervical canal. Typically, the penetration of bacteria occurs if the integrity of the barrier is broken. This pathology often occurs as a consequence of abortion, both artificial and spontaneous, scraping the mucous neck and body of the uterus, which is carried out for diagnostic purposes. Other intrauterine interventions can also cause inflammation. In particular, it is sometimes provokes the IUD is inserted.

Inflammation is manifested rapidly after the above procedures, but also after birth. Postpartum endometritis   is the most frequent manifestation of acute infection after childbirth. This disease is more common in women who have undergone cesarean section   (about 45% of new mothers suffer from endometritis). Besides that. An important factor contributing to the development of the disease after giving birth, is to reduce the immunity   women during pregnancy.

Inflammation of the acute form of the disease can capture from the muscles of the uterus, which is adjacent to the endometrium (a form of the disease called endomyometritis ). If the disease is very severe, you may marvel at the wall of the uterus completely ( panmetrit ). The symptoms of endometritis occur in the acute form: the woman observes a sharp increase in body temperature, chills, pain in the abdomen. Appear discharge from the genital tract Sometimes they are festering, sometimes - purulent sukrovichnymi. Acute endometritis usually takes about 8-10 days, after which the patient recovers. Complications arise relatively rare, but they have quite serious consequences for the woman's body. Thus, due to the generalization of the process is shown peritonitis, Options, thrombophlebitis of the pelvic veins, pelvic abscess, sepsis. Sometimes the inflammation becomes chronic or subacute form.

Diagnosis of acute forms of endometritis

Initially, the diagnosis of the disease is taken into account a history of the patient intra-specific interventions carried out recently.

Next, the doctor performs a pelvic examination, which determines the existence of an increase in the uterus, its sensitivity to palpation. When endometritis sensitivity marked on each side, in places where there are large lymph vessels.

If you suspect that the development of the acute form of endometritis is important to carry out laboratory tests in which blood revealed leukocytosis, increased erythrocyte sedimentation rate, leukocyte formula shift to the left. Also carried out laboratory analysis of discharge from the genital tract. A study of vaginal smears to determine the leukocyte reaction, the state of the vaginal epithelium, as well as to assess the flora. Sometimes you need to clarify the diagnosis, which is assigned to an ultrasound and diagnostic laparoscopy. Sometimes the doctor prescribes as conduct Biopsy   Endometrial. The differential diagnosis is carried out when endometritis appendicitis . ectopic pregnancy . functional pelvic pain .

The chronic form of endometritis

Chronic endometritis uterus   mainly manifested as a consequence of improper treatment of the acute form of the disease. The transition into the chronic stage of the disease contributes to the frequent scraping of the endometrium, the presence of residues inogrodnyh materials due to suturing after childbirth, the IUD is inserted. According to statistics, chronic endometritis affects about 14% of women. Chronic endometritis often seen on the background of infectious diseases character, which are sexually transmitted.

Chronic inflammation is developing under the influence of secondary infection. In chronic endometrial lining of the uterus formed inflammatory seals, which have a focal character. They usually appear near the glands, as well as the large blood vessels. Because of the long heavy inflammatory process occurs gradually sclerotic vascular changes, fibrosis and other pathological phenomena. As a result, a woman's body is a breach of the current cyclical processes.

The main symptom of chronic endometritis is menstrual dysfunction. At the same time after the end of menstruation in a woman who suffers a chronic form of endometritis observed spotting. There is also a slight increase in the seal and the uterus, ovarian function declines, and may also exhibit other disease of the reproductive system. As a result, women can be spontaneous abortions and infertility. It is not always possible in chronic endometritis transplanting the fertilized egg. Furthermore, in chronic inflammation the endometrium may eventually develop polyps.

Symptoms of chronic endometritis manifested not only violations of the menstrual cycle, and other phenomena. For such a condition characterized by a nagging pain in the abdomen, the presence of purulent serous discharge from the genital tract.

Diagnosis of chronic form of endometritis

As with acute endometritis, the doctor initially draws attention to the patient's medical history. It is important to know whether there has been repeated intrauterine intervention, the use of intrauterine contraceptive devices, whether spontaneous abortions occurred. Also, important information about infertility women of earlier adjourned acute endometritis.

Initially, the patient's physical examination is carried out, in which the specialist can detect the presence of increasing seal and uterus. Required appointed laboratory blood, microscopic examination of the discharge from the genital tract.

For accurate confirmation of the diagnosis performed histological study scraping of the endometrium. It is important to diagnostic curettage in the first phase of the menstrual cycle (approximately day 8). Sometimes in the process of diagnosis is also used hysteroscopy, ultrasound examination. It is important to differentiate chronic endometritis from several other ailments, provoking infertility.

Complications of endometritis

If adequate treatment of endometritis has been taken in a timely manner, the infection may eventually hit the fallopian tubes, as well as engage the deep layers of the uterine. Such exposure may lead to sepsis . infertility   and even cause death. Furthermore, due to the transferred endometritis woman may suffer from placental insufficiency . postpartum hemorrhage . Besides increasing the risk threat abortion .

Treatment of endometriosis

Given the fact that the acute endometritis develops as a consequence of the destruction of the body of microbial infections, a specialist in complex treatment must include the course of a antibiotics . If the treatment works effectively, and acute condition has been cropped, the therapy is supplemented with physiotherapy methods as prescribed by the patient restorative procedures, taking vitamins.

In order to prevent manifestations of chronic endometritis in the days of menstruation the patient is assigned to an additional antibiotics. Antibiotics doctor picked individually, taking into account the sensitivity of the pathogen to them. Depending on the extent of damage is determined by the intensity of the endometrium such therapy.
Often, doctors recommend for several menstrual cycles oral contraceptives . These drugs act on the body of women as anti-inflammatory agents.

In the treatment of chronic endometritis antibiotic therapy is carried out if there is a genital infection. But in chronic disease, usually infection in a woman's body is gone. All the violations in this case have a functional character. Therefore, therapy is initiated in the first place, with the aim of normalizing the functions of the endometrium. Chance of cyclic hormonal agents, reception immunomodulators Physiotherapy.

If a woman has endometrial polyps, intrauterine adhesions, in such a case is assigned to an additional diagnostic curettage, in which control is practiced hysteroscopy. Such a procedure is "clean", which is held after anti-inflammatory therapy, contributes to pregnancy and follow normal gestation.

Pregnancy at endometritis

Endometrium and pregnancy - a combination that causes serious concern to the physician, as in the period of gestation of the child this disease has a negative impact on the course of pregnancy. If the disease is not diagnosed at an early stage, the inflammatory process, continuing to spread the tissues may initially strike the membranes, and later - and the fruit. In this case, the child may die in the womb of a woman. But you should know that early treatment of endometritis to avoid such unfortunate consequences. Therefore, the smallest signs and suspicions must be immediately concerned about the future mother and become an occasion to consult a gynecologist. The doctor prescribed a course of treatment, considering pregnancy.

Disease prevention

To avoid the development of endometriosis, it is important to avoid the factors that provoke inflammation. Women should promptly and properly treat all infectious diseases . diseases that are transmitted sexually And to consult a doctor about the complications that arise after childbirth process. If the doctor determines that a woman is at risk for the development of inflammatory processes in the process of childbirth and after them, in the process of cesarean section and after the patient administered antibiotics.

After delivery, women who are at risk, certainly carried ultrasound, during which you can discover the remains of the placenta, fruit shell and take measures to eliminate this situation. It is important for a woman to comply strictly with all the doctor's recommendations following the personal hygiene, he led the right way of life. Another measure of prevention - regular strengthening of the immune system through proper nutrition, exercise, taking vitamins, tempering.