POSTPARTUM ENDOMETRITIS (Part 1)

The Endometrium is the tissue that lines the womb. It is the mucous membrane that thickens in anticipation of a possible pregnancy. If fertilization occurs and embryo is implanted, the lining stays in place, if not, the endometrium thins and sheds as a menstrual period.

 Endometritis is a term used to describe endometrial inflammation (swelling of the lining of the womb), which is caused by an infection. It may occur during the postpartum period (after the birth of a baby) as an infection may have been introduced during or after labor and delivery. After childbirth, the uterine lining (endometrium) becomes inflamed, which is what postpartum endometritis is. It is a peculiar infection that frequently develops in the first few weeks following delivery.

CAUSES OF POSTPARTUM ENDOMETRISIS

Prolonged Rupture of The Membranes (PROM):  The condition known as prolonged rupture of membranes (PROM) occurs when a woman’s amniotic sac (the membrane that surrounds the fetus that is filled with fluid) ruptures or breaks prior to the start of labor and the amniotic fluid leaks over a protracted length of time. The rupturing of the membranes typically happens during the active stage of labor, indicating the beginning of delivery. However, prolonged rupture of membranes is when the amniotic sac ruptures before the start of labor and the amniotic fluid leakage continues for a long time (often longer than 18 to 24 hours). Early membrane rupture opens the door for bacteria from the cervix or vagina to enter the uterus, resulting in infection.

Prolonged Labor: The longer the labor, the more exposure the uterus and birth canal have to possible bacteria, which increases the chance of infection. When the cervix opens during labor to let the baby pass through, germs can also enter the uterus through this opening.

Chorioamnionitis: An infection known as chorioamnionitis during pregnancy affects the fetal membranes (chorion and amnion) as well as the amniotic fluid. During labor and delivery, the bacteria that caused this infection may move to the uterine cavity, resulting in endometrial infection.

Cesarean Delivery:  The baby is born via incision in the mother’s belly and Womb during a Caesarean delivery, sometimes referred to as a C-section. Despite the fact that C-sections are typically regarded as safe, they do have a higher risk of some problems than vaginal deliveries. The uterus is accessed during a C-section through an incision in the abdomen and uterus. Bacterial contamination at the surgical site is still a potential even when thorough sterile procedures are followed. During the process, bacteria from the skin or the surrounding area may enter the uterus, raising the risk of infection.

Retention or Manual Removal of Placental Fragments in the Uterus:  After delivery, placental pieces that are still in the uterus provide a risk of infection. These retained fragments can get colonized by bacteria from the vagina or the environment, which can cause an infection in the uterine cavity.

Postpartum Hemorrhage (PPH):  Prolonged and uncontrolled bleeding brought on by PPH can raise the risk of infection by fostering the growth of bacteria. In addition, treatments for PPH that involve manual placenta removal or intensive uterine manipulation may spread bacteria to the uterus, increasing the risk of postpartum endometritis.

Bacterial Vaginosis (BV):  A bacterial imbalance in the vagina known as bacterial vaginosis is characterized by an increase in certain bacteria and a decrease in helpful bacteria. It may result in symptoms like a fishy odor, itching, and discomfort. It may also result in abnormal vaginal discharge. Though treatable but if ignored, BV can result in consequences including postpartum endometritis or an elevated risk of pelvic inflammatory disease (PID) or other infections after childbirth. The normal balance of bacteria in the vagina can be upset by BV, which makes it simpler for dangerous germs to enter the uterus and cause infection. The immune system in the vagina may also be weakened by BV, rendering it more vulnerable to bacterial colonization and subsequent infection.

Obesity:  A known risk factor for needing a cesarean section is obesity. Contrary to vaginal delivery, cesarean delivery carries a higher risk of postpartum endometritis, mostly because of the possibility of increased bacterial contamination during the surgical process. Obese people may experience problems with wound healing, including uterine lining healing following childbirth. The surroundings may become more prone to infection as a result of this delayed healing.

SYMPTOMS OF POSTPARTUM ENDOMETRISIS

The symptoms of postpartum endometritis may include:

• High Fever: A high fever (often above 100.4°F or 38°C) after delivery is one of the telltale indications of postpartum endometritis.
• Lower Abdomen Pain or Discomfort: This is a common symptom of postpartum endometritis in women. The pain could be intermittent or can be constant.
• Foul-Smelling Vaginal Discharge: Postpartum endometritis frequently causes an odd discharge from the vagina. Pus may be present in the discharge, which may also have a strong, unpleasant smell.
• Body Pains and Chills: Some women may develop exhaustion, generalized body aches, and chills.
• Appetite Loss: Postpartum endometritis can result in nausea and a loss of appetite.
• Increased Heart Rate: Tachycardia, or an increased heart rate, may occasionally be observed in patients with Endometritis
• Heavy or Protracted Bleeding: Women with postpartum endometritis may experience heavier or protracted postpartum bleeding than usual ………………….……. TO BE CONTINUED