Patient's question:
What are the symptoms of endometritis? Is it treatable?Doctor's answer:
Hello: In acute endometritis, the endometrium is congested, edematous, and infiltrated with inflammatory cells, with purulent discharge in severe cases. Patients may present with fever, abdominal pain, increased vaginal discharge (bloody or purulent). Acute endometritis can further progress to myometritis, salpingitis, and pelvic inflammatory disease, worsening the condition. In the chronic phase, there may be no symptoms, or sometimes irregular vaginal bleeding and menstrual abnormalities.Acute endometritis is primarily characterized by fever, lower abdominal pain, increased leukorrhea (sometimes bloody or malodorous), and mild uterine enlargement with tenderness. Chronic cases also present similarly, but may also include menorrhagia, lower abdominal pain, and significant lumbosacral discomfort.
When treating acute endometritis, routine bacterial culture and drug sensitivity tests are performed to select effective antibiotics. Before test results are available or if testing is not feasible, broad-spectrum antibiotics like penicillin can be used. After a negative skin test, penicillin (800,000–1,600,000 units) is administered intramuscularly twice daily. If the culture identifies aerobic bacteria, gentamicin (80,000 units) is injected intramuscularly every 8 hours. If the culture shows anaerobic bacteria, metronidazole (400 mg orally, three times daily) is more appropriate. If acute endometritis occurs postpartum or postabortion, it is essential to consider whether residual placenta or fetal membranes remain in the uterine cavity. If residual tissue is present, it should be removed after controlling the infection for 48–72 hours, followed by thorough uterine evacuation once the condition stabilizes. Postoperatively, oxytocin (10 units) is injected intramuscularly, and oral preparations like motherwort ointment or postpartum biochemical decoction are given to promote uterine contraction. Antibiotics should continue to be administered.