Endometritis (Intrauterine Inflammation)
Endometritis is a table that occurs in certain sizes after each abortion (miscarriage) and birth. However, if cervical drainage is sufficient and myometrium is not captured by bacteria, the intrauterine uterus becomes a sterile environment within three or four days. Causes such as premature rupture of membranes (premature water before delivery), caesarean delivery, cervicitis and vaginitis, anaemia and low socio-economic level are factors that increase the risk of postpartum endometritis. In acute endometritis, a soft, sensitive uterus and high fever are the most prominent signs of endometritis.
The lochia (postpartum discharge) can be foul-smelling. In severe forms of the disease, tenderness, hypotension and even sepsis can be seen in the abdomen. Microorganisms responsible for puerperal (postpartum) endometritis are often anaerobic streptococci, gram-negative coliforms and Bacteroides species. It is thought that Chlamydia and Mycoplasma species are also included in a significant amount, but they are not always diagnosed because their cultures are difficult. It is not uncommon in gonococcus and is among the responsible factors.
Endometritis can be shown in a chronic and nonspecific picture. This is mostly seen after post-menopausal (primary chronic endometritis), but women with menstrual chronic endometritis also occur. It may also be due to foreign body. If chronic endometritis persists for a very long time, this may lead to atrophy of the tissue by causing tissue malnutrition.
These types of atrophic endometrium after menopause can cause postmenopausal bleeding. Especially in acute endometritis, high doses of antibiotics are given intravenously as a treatment. Full curettage has no place in the treatment of endometritis. In chronic cases with postmenopausal persistent bleeding, hysterectomy is recommended.
In cases where the cervical canal is not blocked for any reason and does not allow normal drainage of the uterus, it can expand by filling with intrauterine inflammatory fluid. This table called pyometrium is mostly seen in older women. It should be remembered that a tumour originating from the cervix or the lower part of the uterus can prevent the drainage and lead to the pyometrium, and cancer should be ruled out, especially in women in the postmenopausal period.
Treatment of the pyometrium is drainage. This procedure should be done under anaesthesia. Despite repeated treatments, hysterectomy can be recommended in pyometrium that does not pass.