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