What causes postpartum endometritis?

Updated: Oct 11, 2019
  • Author: Andy W Wong, MD; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Answer

The Route of delivery is the single most important factor in the development of endometritis. [5]  The risk of endometritis increases dramatically after cesarean delivery. [5, 6]  However, there is some evidence that hospital readmission for management of postpartum endometritis occurs more often in those who delivered vaginally. [6]

Other risk factors include prolonged rupture of membranes, prolonged use of internal fetal monitoring, anemia, and lower socioeconomic status. [5]

Perioperative antibiotics have greatly decreased the incidence of endometritis. [5]

In most cases of endometritis, the bacteria responsible are those that normally reside in the bowel, vagina, perineum, and cervix.

The uterine cavity is usually sterile until the rupture of the amniotic sac. As a consequence of labor, delivery, and associated manipulations, anaerobic and aerobic bacteria can contaminate the uterus.


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