Endometritis : symptoms and treatment , the causes of

What is it?Dysmenorrhea is an inflammatory process in the mucosa and the muscle wall of the uterus.

Usually this pathological process develops after any intrauterine interventions.

The danger of it is that in the absence of timely treatment may develop uterine forms of infertility and other complications that will eventually become irreversible.

Classification


What is it - the nature of endometritis the pathological process may be acute or chronic.In the latter case it flows in waves, ie periods of remission and exacerbation alternate with each other.

By the nature of cause-significant microorganisms endometritis is of two kinds:

  1. 1) specific - associated more often with infection with pathogens (Chlamydia, Mycoplasma, Ureaplasma, gonococci, trichomonas, herpes virus, etc.)
  2. 2).Non-specific, which is caused by the activation of conditionally pathogenic microflora (streptococci, staphylococci, E. coli, Proteus, Pseudomonas).
etiological classification implies the division of endometritis on
species such as:

  1. 1) Bacterial
  2. 2) Viral
  3. 3) Fungal

reasons endometritis


endometrium in women is almost always associated with infectious inflammation.In some cases, it becomes infected with pathogens that always cause the development of the inflammatory response, and in others - activation of opportunistic organisms that live in the vagina.

It is associated with reduced immunity, which may be due to the following factors:

  • pregnancy (decreased activity occurring immune responses)
  • hypo- and beriberi
  • comorbidities
  • diabetes
  • congenitalimmunodeficiency
  • receiving immunosuppressants, etc.
addition allocate local predisposing factors that significantly increase the risk of endometritis.These include a variety of intrauterine intervention, namely:

  • birth
  • introduction of intrauterine contraceptive
  • medical abortion
  • diagnostic curettage of the uterus
  • removal of the nascent myoma node
  • medical (using pharmacological agents)abortion
  • miscarriage.
chronic endometritis, as a rule, is untimely and inadequate treatment of acute inflammation of the uterus.In its development role of the causative microorganism goes by the wayside.

dominant pathological process units are abnormal reaction of the immune system.This eventually leads to further damage to the organ.

Symptoms of endometritis


manifestations of endometritis in women is determined by the degree of severity of the pathological process.

Thus, acute endometritis has bright clinical symptoms and the sudden onset of the disease.The main feature is considered to be the appearance of pain in the abdomen, which are radiating to the lumbar and sacral region, as well as in the crotch and groin.

addition to acute endometritis are also characteristic:

  • fever, which can reach high values ​​depending on the reactivity of the female organism
  • presence of abnormal discharge from the genital tract (usually pus-like), which often have an unpleasant odor
  • slowdownreverse uterine development process after childbirth or curettage of the uterus
  • uterus becomes soft consistency or testovatoy
  • during vaginal examination revealed tenderness on palpation of the uterus
  • in general clinical blood analysis indicated elevated levels of leukocytes, ESR acceleration, shift leukocyte formulaleft
  • increased leukocyte index of intoxication.
In chronic endometritis in remission clinical manifestations are virtually absent.The main manifestations are in the development of complications (see below).

Symptoms of acute endometritis appears only in the acute stage.She reminds manifestations of acute inflammation of the uterus in many ways.

Diagnostics


In unclear clinical cases shows the use of additional diagnostic tests:

  1. 1) Ultrasound examination of the pelvic organs
  2. 2) hysteroscopic study - examination of the uterus using a endoscopic technique
  3. 3) Bacteriologicalstudy to assess the sensitivity to antibiotics separated from the uterus (during the sampling material must adhere to special rules, so as not to contaminate the culture of vaginal discharge).
diagnostic search in chronic endometritis also includes an assessment of immune status.This is necessary for the selection of adequate therapy immunnostimuliruyuschey.

Treatment


endometritis endometritis treatment of acute exacerbation of chronic uterine and held on general principles.They are as follows:

  1. 1) Compliance with bed rest for full recuperation
  2. 2) Dosed application of cold on the lower abdomen (lower temperatures cause spasm of blood vessels, which prevents the further spread of the inflammatory process)
  3. 3) Sufficientdrink, or on the testimony of (a serious condition of the patient) is assigned to infusion therapy
  4. 4) Antibiotic therapy, taking into account the sensitivity of the isolated microorganisms
  5. 5) the use of non-steroidal anti-inflammatory drugs
  6. 6) desensitizing agents that reduce the severity of the allergic disposition of the body
  7. 7) Sedatives are assigned only for emotional lability women
  8. 8) drugs that reduce the womb
  9. 9) Vitamin drugs that normalize the body's metabolism.
In remission of chronic endometritis shows the use of physiotherapy.It is also well-proven spa treatment, allows to restore the normal structure of the uterus.

In the case of acute endometritis, against the background of the intrauterine device, after the stabilization of the state of women and reduce the severity of the inflammatory process, it is recommended to remove the coil.

Otherwise it will maintain inflammation.A similar situation occurs with postpartum endometritis.

In this situation, if there are remnants of decidua, placental tissue, blood clots they are recommended to evacuate, as they are a good breeding ground for microorganisms.

Complications of endometritis


lack of timely diagnosis and treatment of endometriosis in women can lead to complications.

They can be divided into two main groups - short-term (developed in the near future) and long term (occurring after a certain time).The first group includes the following:

  • panmetrit - inflammation of all layers of the uterus
  • oophoritis - inflammation of the uterus
  • Options - inflammation of the tissue surrounding the uterus
  • peritonitis - an inflammation of the peritoneum (pelviopertitonit - inflammation of the peritoneum covering the pelvic organs)
  • abscess Douglas space - purulent inflammation in pozadimatochnom space
  • thrombosis pelvic veins.
Complications of the second group are:

  1. 1) masterbatch form of infertility
  2. 2) adhesions in the pelvic
  3. 3) Syndrome Asherman - the presence of adhesions in the cavity of the uterus
  4. 4) Chronic pelvic pain syndrome -this pain in the lower abdomen, which lasts for 6 months or more.
Considering all the above, it becomes clear that the diagnosis and treatment of endometritis should start as early as possible.Therefore, the appearance of the first signs of the disease, similar to endometriosis, it is necessary to seek medical help from a gynecologist.

In conclusion, it should be noted that often develops endometritis in the postpartum period, after curettage of the uterus and on the background of intrauterine contraceptives.

severity of the clinical picture of the disease depends on the severity of the pathological process.However, to establish a definitive diagnosis is necessary to use additional methods of research.Aftercare should always be comprehensive, taking into account the reasons that led to the development of this pathological process.


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