Prognosis
Etiology
Patient Education
Pathophysiology
Epidemiology
Nearly 90% of women treated with an approved regimen note improvement in 48-72 hours. Delay in initiation of antibiotic therapy can result in systemic toxicity.
Infection of the endometrium, or decidua, usually results from an ascending infection from the lower genital tract. From a pathologic perspective, endometritis can be classified as acute versus chronic. Acute endometritis is characterized by the presence of neutrophils within the endometrial glands. Chronic endometritis is characterized by the presence of plasma cells and lymphocytes within the endometrial stroma.
For patient education information, see the Women's Health Center, Pregnancy and Reproduction Center, and Sexually Transmitted Diseases Center, as well as Pelvic Inflammatory Disease, Sexually Transmitted Diseases, Cesarean Childbirth, and Dilation and Curettage (D&C).
The incidence of postpartum endometritis in the United States varies depending on the route of delivery and the patient population. After a vaginal delivery, incidence is 1-3%. Following cesarean delivery, the incidence ranges from 13-90%, depending on the risk factors present and whether perioperative antibiotic prophylaxis had been given.
Endometritis is a polymicrobial disease involving, on average, 2-3 organisms. In most cases, it arises from an ascending infection from organisms found in the normal indigenous vaginal flora.
