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METRITIS

The uterus, generally known as the womb, is the most delicate organ of a woman. Various kinds of disorders can occur in this and the most common occurrence is the inflammation of the uterus, which can either be sensitive or chronic. The inflammation of the Uterus, which may affect the delicate lining membrane of the uterus, is called Endometritis.
Endometritis is an infection of the endometrium, with extension into the myometrium and parametrial tissues. Endometritis is divided into obstetric and nonobstetric endometritis. It is the most common cause of fever during the postpartum period. Pelvic inflammatory disease (PID) is a common predecessor in the nonobstetric population.
This is more common in females during their reproductive age.

Causes-
Endometritis is caused by infections such as chlamydia, gonorrhea, tuberculosis, or mixtures of normal vaginal bacteria. Endometritis is more likely to occur after childbirth, miscarriage, or placement of an intrauterine device (IUD).

Any surgical procedure that enters the uterus through the cervix will increase the risk of developing endometritis. Endometritis can occur at the same time as other pelvic infections such as acute salpingitis, acute cervicitis, and many sexually transmitted diseases (STDs).

Morbidity/ Mortality

  • Infection of the genital tract is the most common cause of puerperal morbidity. Puerperal morbidity is defined as a temperature of 100.4ºF (38ºC) or higher occurring in any 2 of the first 10 days postpartum, exclusive of the first 24 hours. In the past, infection accounted for up to 16% of maternal mortality.
  • In the nonobstetric population, concomitant endometritis may occur in up to 70-90% of documented cases of salpingitis.
Symptoms-
1.Abdominal distention
2.Abnormal vaginal bleeding
3.Abnormal vaginal discharge
a.Increased amount
b.Unusual color, consistency, or odor
4.Discomfort with bowel movement (constipation may occur)
5.Fever (ranging from 100 to 104 degrees Fahrenheit)
6.General discomfort, uneasiness, or ill feeling (malaise)
7.Lower abdominal or pelvic pain (uterine pain)

Signs and tests:
The health care provider will perform a physical exam and a pelvic exam. The lower abdomen may be tender. Bowel sounds may be decreased. A pelvic exam may cause the uterus and cervix to feel tender. There may be cervical discharge.

Other problems to be considered
1.Appendicitis
2.Pelvic Inflammatory disease
3.Pyelonephritis
4.Thrombophlebitis
5.Viral syndrome

Investigations-
Laboratory Studies
1.On complete blood count the finding of leukocytosis may be difficult to interpret, secondary to the physiologic leukocytosis of pregnancy.
2.Blood culture is positive in 10-30% of cases.
3.Urine culture should be ordered.
4.Endocervical cultures (or DNA probe) are obtained for gonorrhea and chlamydia.

Imaging Studies
1.Perform imaging studies on patients who do not respond to adequate antimicrobial therapy in 48-72 hours.
2.CT scanning of the abdomen and pelvis may be helpful for excluding broad ligament masses, septic pelvic thrombophlebitis, ovarian vein thrombosis, and phlegmon.
3.Sonographic findings of the abdomen to diagnosed it.

Complications-
1.Infertility
2.Pelvic peritonitis (generalized pelvic infection)
3.Pelvic or uterine abscess formation
4.Septicemia
5.Septic shock

Prognosis-
Most cases of endometritis go away with antibiotics. Untreated endometritis can lead to more serious infection and complications with pelvic organs, reproduction, and general health.

Treatment-
1.Medications.
2.Diet- the diet should aim at increasing general vitality when in the chronic form.
3.Exercise- Exercises and Asanas also cure inflammation of the uterus steadily. The patient should also undertake moderate exercise and walking in fresh air, as it will help increase general health and vitality.
4.Complicated cases (those occurring after childbirth or involving severe symptoms) may require the patient to be admitted to a hospital. Intravenous (in the vein) antibiotics are usually needed, followed by antibiotics taken by mouth.
5.Rest and hydration are important.
6.Treatments for sexual partners, when appropriate, and the use of condoms throughout the course of treatment, are essential.

Role of homoeopathy
Homeopathy is a safe, natural form of medicine, based on the practice of treating like with like. The homeopath will consider the patient as a whole, both physically and psychologically and help cure the metritis.

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