ENDOMETRITIS
A. Acute endometritis e.g. post-abortive & post-operative.
B. Chronic endometritis:
1. During childbearing period: uncommon
– Protective mechanisms in this age e.g. monthly shedding of endometrium.
– Some organisms can affect endometrium even in this age e.g. TB.
2. After menopause: senile endometritis.
Malignancy should be excluded after control of infection by fractional curettage.
PYOMETRA
Pyometra definition:
A condition in which the uterus is distended with pus.
Pyometra aetiology:
(infection + obstruction).
1. Neoplastic e.g. cancer cervix & cancer endometrium.
2.Inflammatory e.g. senile endometritis & cervical stenosis after radiotherapy.
Pyometra diagnosis:
A. Symptoms:
1. General: fever, anorexia, headache & malaise.
2. Local: suprapubic colicky pain with passage of purulent discharge.
B. Signs:
1. General: fever & tachycardia.
2. Local:
– Uterus: symmetrically enlarged, tender & soft.
– Passage of pus on sounding.
Pyometra treatment:
1. Drainage under general anesthesia.
2. Antibiotics are given.
3. Fractional curettage after 2 weeks to exclude malignancy.
4. Hysterectomy in resistant cases.
Parametritis (pelvic cellulitis)
Parametritis definition:
Inflammation of pelvic cellular tissue of parametrium (C.T. between 2 layers of broad ligament).
Parametritis diagnosis:
• General: fever.
• Local: deep pelvic pain & indurated mass lateral to the uterus.
Parametritis complications:
Parametric abscess (can open through one of six possible sites).
Parametritis treatment:
Antibiotics & drainage of parametric abscess.
Endometritis, pyometra and parametritis videos:
Endometritis – CRASH! Medical Review Series video
(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)
What is ENDOMETRITIS? video
It is inflammation of the endometrium, the inner lining of the uterus. Pathologists have traditionally classified it as either acute or chronic: 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 it 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. Treatment is usually with broad-spectrum antibiotics.
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. Pyometra describes an accumulation of pus in the uterine cavity. In order for pyometra to develop, there must be both an infection and blockage of cervix. Signs and symptoms include lower abdominal pain (suprapubic), rigors, fever, and the discharge of pus on introduction of a sound into the uterus. Pyometra is treated with antibiotics, according to culture and sensitivity.
Endometritis, pyometra and parametritis PPT(power point presentations):
ENDOMETRITIS MIDWIFERY SUBJECT FOR CORE CORSE R.N. Zainab Neamat Jumaah PPT
It is caused by an infection in the uterus. It can be due to chlamydia, gonorrhea, tuberculosis, or a mix of normal vaginal bacteria. It is more likely to occur after miscarriage or childbirth. It is also more common after a long labor or C-section.
ENDOMETRITIS MUHAMMAD ZAID SHOKAT International School of Medicine PPT
Explains the inflammatory process of endometrium,its causes and its two clinical variants as acute and chronic .
Describes the pathology of its two types with histologic perspective.