Skip to main content
PMC home page
Infectious Diseases in Obstetrics and Gynecology logoLink to Infectious Diseases in Obstetrics and Gynecology
. 1995;3(5):210–216. doi: 10.1155/S1064744995000640

Postpartum Endomyometritis

Katherine L Williams 1,✉, Joseph G Pastorek II 1
PMCID: PMC2366154  PMID: 18472894

Abstract

Endomyometritis following parturition is a major cause of maternal morbidity. It is most common following cesarean delivery, especially in certain high-risk patient populations. The infection is usually caused by bacteria in the cervicovaginal tract that are inoculated into the uterus during labor and delivery. Both anaerobes and aerobes are thought to be involved in the disease process. A prompt diagnosis based on clinical suspicion, a thorough physical examination, and adjunctive laboratory measures is necessary to insure effective therapy and prompt resolution of the infection. The treatment consists of supportive care and broad-spectrum antibiotic coverage either with single extended-spectrum drugs or with combinations of antimicrobials. In cases appropriately treated, recovery without sequelae is the rule.

Full Text

The Full Text of this article is available as a PDF (610.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrews W. W., Shah S. R., Goldenberg R. L., Cliver S. P., Hauth J. C., Cassell G. H. Association of post-cesarean delivery endometritis with colonization of the chorioamnion by Ureaplasma urealyticum. Obstet Gynecol. 1995 Apr;85(4):509–514. doi: 10.1016/0029-7844(94)00436-H. [DOI] [PubMed] [Google Scholar]
  2. Berenson A. B., Hammill H. A., Martens M. G., Faro S. Bacteriologic findings of post-cesarean endometritis in adolescents. Obstet Gynecol. 1990 Apr;75(4):627–629. [PubMed] [Google Scholar]
  3. Blanco J. D., Gibbs R. S. Infections following classical cesarean section. Obstet Gynecol. 1980 Feb;55(2):167–169. [PubMed] [Google Scholar]
  4. Cooperman N. R., Kasim M., Rajashekaraiah K. R. Clinical significance of amniotic fluid, amniotic membranes, and endometrial biopsy cultures at the time of cesarean section. Am J Obstet Gynecol. 1980 Jul 1;137(5):536–542. doi: 10.1016/0002-9378(80)90692-4. [DOI] [PubMed] [Google Scholar]
  5. DiZerega G. S., Yonekura M. L., Keegan K., Roy S., Nakamura R., Ledger W. Bacteremia in post-Cesarean section endomyometritis: differential response to therapy. Obstet Gynecol. 1980 May;55(5):587–590. [PubMed] [Google Scholar]
  6. Duff P., Gibbs R. S., Blanco J. D., St Clair P. J. Endometrial culture techniques in puerperal patients. Obstet Gynecol. 1983 Feb;61(2):217–222. [PubMed] [Google Scholar]
  7. Faro S. Group B streptococcus and puerperal sepsis. Am J Obstet Gynecol. 1980 Dec 15;138(8):1219–1220. doi: 10.1016/s0002-9378(16)32795-8. [DOI] [PubMed] [Google Scholar]
  8. Gilstrap L. C., 3rd, Cunningham F. G. The bacterial pathogenesis of infection following cesarean section. Obstet Gynecol. 1979 May;53(5):545–549. [PubMed] [Google Scholar]
  9. Hager W. D., Pascuzzi M., Vernon M. Efficacy of oral antibiotics following parenteral antibiotics for serious infections in obstetrics and gynecology. Obstet Gynecol. 1989 Mar;73(3 Pt 1):326–329. [PubMed] [Google Scholar]
  10. 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]
  11. Hurry D. J., Larsen B., Charles D. Effects of postcesarean section febrile morbidity on subsequent fertility. Obstet Gynecol. 1984 Aug;64(2):256–260. [PubMed] [Google Scholar]
  12. Isaacs J. D., Magann E. F., Martin R. W., Chauhan S. P., Morrison J. C. Obstetric challenges of massive obesity complicating pregnancy. J Perinatol. 1994 Jan-Feb;14(1):10–14. [PubMed] [Google Scholar]
  13. Jakobi P., Weissman A., Sigler E., Margolis K., Zimmer E. Z. Post-cesarean section febrile morbidity. Antibiotic prophylaxis in low-risk patients. J Reprod Med. 1994 Sep;39(9):707–710. [PubMed] [Google Scholar]
  14. Letterie G. S. Serum gentamicin concentrations in postpartum endomyometritis. Mil Med. 1992 Oct;157(10):526–529. [PubMed] [Google Scholar]
  15. Martens M. G., Faro S., Hammill H. A., Riddle G. D., Smith D. Transcervical uterine cultures with a new endometrial suction curette: a comparison of three sampling methods in postpartum endometritis. Obstet Gynecol. 1989 Aug;74(2):273–276. [PubMed] [Google Scholar]
  16. Martens M. G., Faro S., Hammill H., Phillips L. E., Riddle G. D. Comparison of two endometrial sampling devices. Cotton-tipped swab and double-lumen catheter with a brush. J Reprod Med. 1989 Nov;34(11):875–879. [PubMed] [Google Scholar]
  17. Martens M. G., Faro S., Maccato M., Riddle G., Hammill H. A. Susceptibility of female pelvic pathogens to oral antibiotic agents in patients who develop postpartum endometritis. Am J Obstet Gynecol. 1991 May;164(5 Pt 2):1383–1386. doi: 10.1016/0002-9378(91)91477-e. [DOI] [PubMed] [Google Scholar]
  18. McGregor J. A., Crombleholme W. R., Newton E., Sweet R. L., Tuomala R., Gibbs R. S. Randomized comparison of ampicillin-sulbactam to cefoxitin and doxycycline or clindamycin and gentamicin in the treatment of pelvic inflammatory disease or endometritis. Obstet Gynecol. 1994 Jun;83(6):998–1004. doi: 10.1097/00006250-199406000-00020. [DOI] [PubMed] [Google Scholar]
  19. Monif G. R. Intrapartum bacteriuria and postpartum endometritis. Obstet Gynecol. 1991 Aug;78(2):245–248. [PubMed] [Google Scholar]
  20. Repke J. T., Spence M. R., Calhoun S. Risk factors in the development of cesarean section infection. Surg Gynecol Obstet. 1984 Feb;158(2):112–116. [PubMed] [Google Scholar]
  21. Rosene K., Eschenbach D. A., Tompkins L. S., Kenny G. E., Watkins H. Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin. J Infect Dis. 1986 Jun;153(6):1028–1037. doi: 10.1093/infdis/153.6.1028. [DOI] [PubMed] [Google Scholar]
  22. Seo K., McGregor J. A., French J. I. Preterm birth is associated with increased risk of maternal and neonatal infection. Obstet Gynecol. 1992 Jan;79(1):75–80. [PubMed] [Google Scholar]
  23. Soper D. E., Kemmer C. T., Conover W. B. Abbreviated antibiotic therapy for the treatment of postpartum endometritis. Obstet Gynecol. 1987 Jan;69(1):127–130. [PubMed] [Google Scholar]
  24. Temmerman M., Chomba E. N., Ndinya-Achola J., Plummer F. A., Coppens M., Piot P. Maternal human immunodeficiency virus-1 infection and pregnancy outcome. Obstet Gynecol. 1994 Apr;83(4):495–501. doi: 10.1097/00006250-199404000-00002. [DOI] [PubMed] [Google Scholar]
  25. Temmerman M., Njagi E., Nagelkerke N., Ndinya-Achola J., Plummer F. A., Meheus A. Mass antimicrobial treatment in pregnancy. A randomized, placebo-controlled trial in a population with high rates of sexually transmitted diseases. J Reprod Med. 1995 Mar;40(3):176–180. [PubMed] [Google Scholar]
  26. Watts D. H., Eschenbach D. A., Kenny G. E. Early postpartum endometritis: the role of bacteria, genital mycoplasmas, and Chlamydia trachomatis. Obstet Gynecol. 1989 Jan;73(1):52–60. [PubMed] [Google Scholar]
  27. Yonekura M. L. Treatment of postcesarean endomyometritis. Clin Obstet Gynecol. 1988 Jun;31(2):488–500. doi: 10.1097/00003081-198806000-00023. [DOI] [PubMed] [Google Scholar]

Articles from Infectious Diseases in Obstetrics and Gynecology are provided here courtesy of Wiley

RESOURCES