Endometritis
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Endometritis
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Ampicillin
endometritis p. 658
Childbirth
endometritis after p. 658
Clindamycin
endometritis p. 658
Endometritis p. 658
Gentamicin p. 184, 188
endometritis p. 658
Intrauterine device (IUD)
endometritis p. 658
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Endometritis is an inflammation of the endometrium, which is the inner lining of the uterus.
It is usually caused by an infection of the endometrium from bacteria that normally live in the female lower genital tract, but it could also be caused by bacteria from outside the body.
The female reproductive system is divided into upper and lower genital tracts.
The upper genital tract consists of the uterus, ovaries, and fallopian tubes.
The lower genital tract in turn consists of the cervix, vagina and the external genitals, which includes the labia and the clitoris.
Now, The uterus consists of 3 layers, an outer thin layer called the perimetrium or the serosa, a middle smooth muscle layer called the myometrium, and the innermost layer, the endometrium.
The endometrium has two layers, an inner functional layer made up mainly of glands and supporting connective tissue, called stroma, and an outer thin basal layer which regenerates the overlying functional layer after each menstrual cycle.
Alright, normally, there are many species of bacteria living in the female’s lower genital tract, and this is called the normal flora.
These include Ureaplasma urealyticum, Peptostreptococcus and group B Streptococcus.
Under normal conditions, these bacteria live there happily without causing any harm, however, if they reach the upper genital tract, they can cause an infection like endometritis if they make it to the uterus.
Endometritis is a common problem during pregnancy because bacteria can easily reach the uterus during childbirth.
Okay, so normally the fetus is surrounded by membranes and amniotic fluid, and the uterus’s opening is sealed by a mucous plug.
This mucus plug has antimicrobial properties, preventing bacteria from reaching the uterus. Typically, during vaginal delivery, the mucus plug is shed, the cervix widens, and the membranes around the fetus rupture, so the baby can be delivered.
Summary
Endometritis refers to inflammation of the endometrium, the inner lining of the uterus. It is usually caused by normal flora of the genital tract if the endometrium is breached, but can also be caused by sexually transmitted infections, such as Chlamydia trachomatis and Neisseria gonorrhoeae infections.
Common symptoms are fever, pain in the pelvis or lower abdomen, abnormal vaginal discharge, and painful sexual intercourse. Procedures which can lacerate the endometrium such as childbirth, abortion, surgery on the uterus or other pelvic organs, and insertion of an intrauterine contraceptive device (IUD), all increase a chance of having endometritis.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "An in vitro study of antibacterial properties of the cervical mucus plug in pregnancy" American Journal of Obstetrics and Gynecology (2001)
- "The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology" American Journal of Obstetrics and Gynecology (2018)