Endometritis, an infection that affects the lining of the uterus, is a serious condition if not treated quickly. Developing mainly after childbirth, this infection must be detected in time to avoid any complications.

Endometritis is inflammation of the endometrium, a lining that lines the cavity of the uterus. It is always caused by an infection. Infections that can cause endometritis are:

• Sexually transmitted infections (STIs), such as chlamydia, mycoplasma, and gonorrhea. STIs represent 50% of the causes of endometritis.
• Tuberculosis
• A change in the vaginal flora. Douching should therefore be avoided because they “wash” the normal vaginal flora and thus increase the risk of contamination.
• But also everything that touches the intrauterine mucosa: abortion and childbirth that can leave placental debris, the incorrect placement of an IUD, etc.
• Certain factors are predisposing to infection: prolonged labor, repeated digital rectal examination, anemia, internal monitoring of a fetus, etc.

Endometritis accounts for 2-3% of postpartum infections.

Endometritis usually presents in an acute form and is diagnosed quickly. However, a chronic form of the infection exists. It is important to look for the presence of chronic endometritis in several situations: in women who have repeated miscarriages, as part of the sterility assessment and finally in failure of inseminations or IVF. The persistence of pain and / or abnormal bleeding can also be explained by the presence of chronic endometritis.

The symptoms of endometritis occur in two stages. The early symptoms, within 24 to 48 hours, will be:

• Unusual, heavy, fragrant vaginal discharge
• Bleeding outside of your period
• Fever
• Severe abdominal pain
• Tachycardia, headache, sleep disturbance, increased sweating, malaise

Later signs, mainly in chronic endometritis, will appear:

• Constipation
• Irregular periods
• Pregnancy difficulties

The diagnosis is made by gynecological examination. A vaginal sample is then necessary to ascertain the infection. A blood test may also be ordered to find out what stage the endometritis is at.

Endometritis is treated with antibiotics, usually with eggs. The treatment lasts between 10 days and 3 weeks. The infected person’s sexual partner may also need to be treated if the route of transmission is an STI to prevent recurrence or mutual contagion.

Probiotics can also help restore vaginal microflora.

Complex cases may require intravenous administration and hospital stay. Particularly in cases where the infection follows childbirth.

If the infection follows childbirth or an abortion, placental debris may still be present and should be removed by the doctor. A curettage is then prescribed. If endometritis is the consequence of inserting an IUD, it must be removed and another method of contraception should be considered.

If endometritis is treated correctly and on time, it will not affect a pregnant woman. On the other hand, if the infection is not treated, it could interfere with the normal development of the pregnancy and lead to a miscarriage or an ectopic pregnancy.

Endometritis needs to be taken care of quickly. Indeed, taken in time, the treatments are effective however, potential complications can arise if the disease is not treated:

• Infertility
• Pelvic peritonitis
• Abscess in the pelvis or uterus
• Septicemia
• Septic shock

The risk of death is 10-17 per 100 in developed countries. 

During childbirth or any other gynecological procedure, it is essential to ensure that the equipment used is sterile. In the case of a risky procedure (delivery by cesarean section or surgery), the doctor may prescribe antibiotics to be taken as a precaution. 

It is also possible to reduce the risk of endometritis caused by STIs:

• Safe sex: condoms
• Perform routine screening and early diagnosis of STIs
• Take all prescribed treatments for an STI to the end
• Respect personal hygiene
• Regularly change intimate protection during menstruation (tampons, sanitary napkins, cup)