Patient's question:
I had an abortion a while ago, and later I was diagnosed with endometritis. The doctor told me to receive intravenous fluids during my menstrual period, which were clindamycin (brand name: Fuduo). A few days ago, I started my period and began the infusion, but it only lasted for two days before stopping. So, I only received the infusion for two days. Is what I did correct? How should I use the medication reasonably? Can endometritis be cured completely?Doctor's answer:
Hello: When experiencing significant abdominal pain after a miscarriage or postpartum, it is important to seek medical attention promptly. If diagnosed with acute endometritis, it is essential to follow the doctor's advice and take an adequate dosage of medication for thorough treatment. Additionally, rest in bed, preferably in a semi-recumbent position, to localize inflammatory exudates in the lowest part of the pelvic cavity and facilitate the discharge of lochia. Maintain external genital hygiene by cleaning the area daily and changing underwear to prevent reinfection. In terms of dietary care, drink plenty of water and consume a diet rich in protein and vitamins. Abstain from sexual activity during the illness. Keep the living space warm, well-ventilated, and fresh, while avoiding excessive clothing to prevent excessive sweating. Clothing and bedding should be comfortably warm and cool.When treating acute endometritis, routine bacterial culture and drug sensitivity tests are performed to select effective antibiotics. Before test results are available or when testing is not feasible, penicillin can be used as a broad-spectrum antibiotic. After a negative skin test, administer penicillin 800,000–1,600,000 units, injected intramuscularly twice daily. If the bacterial culture reveals aerobic bacteria, gentamicin can be administered intramuscularly at 80,000 units per dose, every 8 hours. If the culture results show anaerobic bacteria, metronidazole is more appropriate, taken orally at 0.4 grams per dose, three times daily.
If acute endometritis occurs postpartum or after a miscarriage, consider whether there are residual placenta or fetal membranes in the uterine cavity. If residual tissue remains in the cavity, it should be removed after controlling the infection for 48–72 hours, followed by a thorough uterine evacuation once the condition stabilizes. Postoperatively, administer oxytocin 10 units intramuscularly and take oral preparations like motherwort ointment or postpartum biochemical decoction to promote uterine contractions. Antibiotics should continue to be used.