Endometritis is a inflammation of the endometrium, the inner lining of the uterus. It can be classified as acute endometritis and chronic endometritis according to the time span of it. Acute endometritis is characterized by the presence of microabscesses or neutrophils within the endometrial glands, while chronic endometritis is distinguished by variable numbers of plasma cells within the endometrial stroma. The most common cause of endometritis is infection. Symptoms include lower abdominal pain, fever and abnormal vaginal bleeding or discharge. Caesarean section, prolonged rupture of membranes and long labor with multiple vaginal examinations are important risk factors.
Acute Endometritis
Acute Endometritis is characterized by infection. The disease often occur after compromised abortions, delivery, medical instrumentation, and retention of placental fragments. Histologically, neutrophilic infiltration of the endometrial tissue is present during acute endometritis.
The clinical presentation is typically high fever and purulent vaginal discharge. There could be edema and hyperemia of the endometrium. Menstruation after acute endometritis is excessive and in uncomplicated cases can resolve after 2 weeks of clindamycin and gentamicin IV antibiotic treatment. In the treatment of acute endometritis, not only proper antibiotics are necessary, but also the incentive of the disease, such as IUDs or endometrial polyp should be eliminated.
There should be no sexual intercourses during the treatment in order to prevent from the spread of the inflammation.
Acute endometritis can be treatment with proper prescription of traditional Chinese herbs too.
Chronic Endometritis
Chronic Endometritis is a chronic inflammation of endometrium. Some acute endometritis transform into an chronic disease. The disease can also be the result of severe cervicitis or
salpingitis. IUDs, abortion and delivery can also be the causes of the disease. Women who are menopausal can be attacked by the disease because the hormones's reduce and the thinning of endometrium and vaginal lining.
Chronic granulomatous endometritis is most often tuberculous in etiology. The granulomas are small, sparse, and without caseation. The granulomas take up to 2 weeks to develop and since the endometrium is shed every 4 weeks, the granulomas are poorly formed.
In human medicine pyometra (also a veterinary condition of significance) is regarded as a form of chronic endometritis seen in elderly women causing stenosis of the cervical os and accumulation of discharges and infection. Symptom in chronic endometritis is blood stained discharge but in pyometra the patient complaints of lower abdominal pain.
Key words: endometritis; acute endmetritis; chronic endometritis; endometritis symptpms
