Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about postpartum endometritis. And you can find written notes on this topic at

zero to finals.com slash endometritis or in the postnatal care section of the zero definals

obstetrics and gynecology book so let's get straight into it endometritis refers to inflammation of

the endometrium which is the lining of the uterus, usually caused by infection.

It can occur in the postpartum period as infection is introduced during or after labour and delivery of the baby.

The process of delivery opens the uterus and allows bacteria from the vagina to travel

upwards and infect the endometrium. Endometriitis occurs more commonly after cesarean

section compared to vaginal delivery. Prophylactic antibiotics are given during a caesarean section

to reduce the risk of infection.

Endometriitis can be caused by a large variety

of gram-negative, gram-positive and anaerobic bacteria.

It can also be caused by sexually transmitted infections such as chlamydia and gonorrhea.

When endometritis occurs unrelated to pregnancy and delivery, it's usually part of pelvic inflammatory

disease or PID.

Let's talk about the presentation.

Postpartum endometritis can present from shortly after birth to several weeks postpartum

and it presents with foul-smelling discharge or lochia, bleeding that gets heavier or does not improve with time, lower abdominal or pelvic pain,

fever or even sepsis. Let's talk about diagnosis and management. Investigations to help

establish the diagnosis include vaginal swabs, including

chlamydia and gonorrhea if there are risk factors, and urine culture and sensitivities.

An ultrasound scan may be considered to rule out retained products of conception.

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