Abstract
Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya. These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04). Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups. Histology showed plasma cell infiltration in 6/25 patients compared with 1/22 controls (p = 0.06). A history of foul lochia (p less than 0.01) and abdominal pain (p = 0.02) were associated with postpartum endometritis. Sexually transmitted agents appear to be major causes of puerperal upper genital tract infections in Nairobi.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Belsey M. A. The epidemiology of infertility: a review with particular reference to sub-Saharan Africa. Bull World Health Organ. 1976;54(3):319–341. [PMC free article] [PubMed] [Google Scholar]
- Eschenbach D. A., Rosene K., Tompkins L. S., Watkins H., Gravett M. G. Endometrial cultures obtained by a triple-lumen method from afebrile and febrile postpartum women. J Infect Dis. 1986 Jun;153(6):1038–1045. doi: 10.1093/infdis/153.6.1038. [DOI] [PubMed] [Google Scholar]
- Gibbs R. S., O'DELL T. N., MacGregor R. R., Schwarz R. H., Morton H. Puerperal endometritis: a prospective microbiologic study. Am J Obstet Gynecol. 1975 Apr 1;121(7):919–925. doi: 10.1016/0002-9378(75)90909-6. [DOI] [PubMed] [Google Scholar]
- Hoyme U. B., Kiviat N., Eschenbach D. A. Microbiology and treatment of late postpartum endometritis. Obstet Gynecol. 1986 Aug;68(2):226–232. [PubMed] [Google Scholar]
- Knuppel R. A., Scerbo J. C., Dzink J., Mitchell G. W., Jr, Cetrulo C. L., Bartlett J. Quantitative transcervical uterine cultures with a new device. Obstet Gynecol. 1981 Feb;57(2):243–248. [PubMed] [Google Scholar]
- Laga M., Plummer F. A., Nzanze H., Namaara W., Brunham R. C., Ndinya-Achola J. O., Maitha G., Ronald A. R., D'Costa L. J., Bhullar V. B. Epidemiology of ophthalmia neonatorum in Kenya. Lancet. 1986 Nov 15;2(8516):1145–1149. doi: 10.1016/s0140-6736(86)90544-1. [DOI] [PubMed] [Google Scholar]
- Ledger W. J., Gee C. L., Pollin P. A., Lewis W. P., Sutter V. L., Finegold S. M. A new approach to patients with suspected anaerobic postpartum pelvic infections. Transabdominal uterine aspiration for culture and metronidazole for treatment. Am J Obstet Gynecol. 1976 Sep 1;126(1):1–6. doi: 10.1016/0002-9378(76)90455-5. [DOI] [PubMed] [Google Scholar]
- McCormack W. M., Lee Y. H., Lin J. S., Rankin J. S. Genital mycoplasmas in postpartum fever. J Infect Dis. 1973 Feb;127(2):193–196. doi: 10.1093/infdis/127.2.193. [DOI] [PubMed] [Google Scholar]
- Mishell D. R., Jr, Moyer D. L. Association of pelvic inflammatory disease with the intrauterine device. Clin Obstet Gynecol. 1969 Mar;12(1):179–197. doi: 10.1097/00003081-196903000-00010. [DOI] [PubMed] [Google Scholar]
- Paavonen J., Teisala K., Heinonen P. K., Aine R., Laine S., Lehtinen M., Miettinen A., Punnonen R., Grönroos P. Microbiological and histopathological findings in acute pelvic inflammatory disease. Br J Obstet Gynaecol. 1987 May;94(5):454–460. doi: 10.1111/j.1471-0528.1987.tb03125.x. [DOI] [PubMed] [Google Scholar]
- Pezzlo M. T., Hesser J. W., Morgan T., Valter P. J., Thrupp L. D. Improved laboratory efficiency and diagnostic accuracy with new double-lumen-protected swab for for endometrial specimens. J Clin Microbiol. 1979 Jan;9(1):56–59. doi: 10.1128/jcm.9.1.56-59.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Piot P., Van Dyck E., Godts P., Vanderheyden J. The vaginal microbial flora in non-specific vaginitis. Eur J Clin Microbiol. 1982 Oct;1(5):301–306. doi: 10.1007/BF02019976. [DOI] [PubMed] [Google Scholar]
- Platt L. D., Yonekura M. L., Ledger W. J. The role of anaerobic bacteria in postpartum endomyometritis. Am J Obstet Gynecol. 1979 Nov 15;135(6):814–817. doi: 10.1016/0002-9378(79)90397-1. [DOI] [PubMed] [Google Scholar]
- Plummer F. A., Laga M., Brunham R. C., Piot P., Ronald A. R., Bhullar V., Mati J. Y., Ndinya-Achola J. O., Cheang M., Nsanze H. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors. J Infect Dis. 1987 Jul;156(1):92–98. doi: 10.1093/infdis/156.1.92. [DOI] [PubMed] [Google Scholar]
- Spore W. W., Moskal P. A., Nakamura R. M., Mishell D. R., Jr Bacteriology of postpartum oviducts and endometrium. Am J Obstet Gynecol. 1970 Jun 15;107(4):572–577. doi: 10.1016/s0002-9378(16)33944-8. [DOI] [PubMed] [Google Scholar]
- Wager G. P., Martin D. H., Koutsky L., Eschenbach D. A., Daling J. R., Chiang W. T., Alexander E. R., Holmes K. K. Puerperal infectious morbidity: relationship to route of delivery and to antepartum Chlamydia trachomatis infection. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):1028–1033. doi: 10.1016/0002-9378(80)91102-3. [DOI] [PubMed] [Google Scholar]
- Wallace R. J., Jr, Alpert S., Browne K., Lin J. S., McCormack W. M. Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever. Obstet Gynecol. 1978 Feb;51(2):181–185. [PubMed] [Google Scholar]
- Walton S. M., Mati J. K. An evaluation of secondary infertility in Kenya. East Afr Med J. 1976 Jun;53(6):310–314. [PubMed] [Google Scholar]