- Postpartum Endometritis
- typically presents with fever, uterine tenderness, and lower abdominal pain, which is typically significant.
- Additionally, lochia may be purulent, foul-smelling, and heavier than usual due to subinvolution of the uterus (which is more common with uterine infections).
- Generalized symptoms such as
- Malaise
- headache
- and chills may
- On physical exam
- suprapubic and uterine tenderness is typically pronounced, and additional vital sign abnormalities such as tachycardia are also common.
- Risk factors for postpartum endometritis include:
- Cesarean delivery (most important risk factor)
- Infections/bacterial colonization present during labor and delivery, including intrapartum intraamniotic infection (also known as chorioamnionitis), bacterial vaginosis, Group B streptococcus (GBS), and STIs
- Prolonged rupture of membranes and/or prolonged labor
- Insertion of foreign bodies into the uterus, including multiple cervical examinations, invasive maternal/fetal monitoring devices, and manual extraction of the placenta
- Operative vaginal delivery
- Maternal factors: HIV infection, diabetes mellitus, and obesity
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