How to treat uterine endometrial hyperplasia. Endometritis: causes, types, symptoms and treatment. Symptoms of chronic course

By modern ideas, endometritis, or inflammation of the uterine mucosa, is classified as pelvic inflammatory disease (PID) in women. According to the observations of doctors, in lately All over the world, there is a clear trend towards an increase in the incidence of PID, including endometritis.

Of particular danger is the chronic course of the disease, the prevalence of which, according to various sources, ranges from 10 to 85%. This wide range is due to the difficulty of diagnosis and mild symptoms chronic endometritis. The disease is often detected already at the stage of complications: for example, miscarriage or infertility. In this regard, the question becomes particularly relevant: is it possible to cure endometritis and prevent the development of its consequences?

Endometritis does not predict reproductive morbidity after pelvic inflammatory disease. Endometrial microlips on liquid hysteroscopy suggest the existence of chronic endometritis. Correspondence between hysteroscopic and histological findings in women with chronic endometritis. Chronic endometritis due to common bacteria is common in women with recurrent miscarriages, as demonstrated by improved pregnancy outcomes after antibiotic treatment. Hysteroscopy and histological diagnosis and treatment of chronic endometritis in patients with recurrent implantation.

A little anatomy

Before answering the question: what is endometritis, it is necessary to briefly dwell on anatomical features uterine walls. As is known, its structure consists of three layers or shells:

External (perimetry).
Muscular (myometrium).
Internal (endometrium).

The endometrium is abundantly supplied with blood and is a hormonally dependent tissue. It, in turn, is formed by two layers:

Efficiency of the Isaac cell sampler for endometrial cultures. Sterility of the uterine cavity. Bacterial colonization non-pregnant uterus: A study of premenopausal abdominal hysterectomy specimens. Elevated vaginal pH and neutrophils are strongly associated with early spontaneous preterm labor.

Antibacterial activity of the mucous membrane of the human cervix. Antimicrobial factors in the mucous membrane of the cervix. Differential expression of natural antimicrobials, beta-defensins 3 and 4, in the human endometrium. Menstruation as protection against pathogens transported by sperm.

Superficial or functional. Consists of columnar epithelium and many glands. This part of the endometrium of the uterus is “responsible” for the normal attachment (implantation) of the embryo. If conception does not occur, this layer falls off and is removed from the uterus during menstrual bleeding.
Basal or sprout. Connects to the underlying muscle layer. Causes restoration of the superficial part of the endometrium.

The thickness of the endometrium directly depends on the effects of female sex hormones during menstrual cycle, reaching its maximum in the luteal phase. At the same time, its structure also changes.

Application of biofilm science to study and control chronic bacterial infections. Enterococcus Endococcal endocarditis in a patient with transposition of great vessels. Is the environment of otitis a biofilm secretion? Direct evidence of bacterial biofilms in otitis media.

Plaque biofilm control. Pathophysiology and treatment of sepsis. The role of growth factors and cytokines during implantation: endocrine and paracrine interactions. Expression of macrophage inflammatory protein-1beta in human endometrium: its role in endometrial natural killer cell recruitment. The answer is not simple.

In this way the uterus prepares for possible pregnancy, causing everything necessary conditions for normal attachment and further development embryo.

Endometritis - what is it?

This term literally means “inflammation of the endometrium (inner lining of the uterus).” Endometritis in women usually develops in childbearing age, causing many problems that affect the possibility of conceiving and carrying a pregnancy in the future.

Infection concept lower sections genital tract with chlamydia or gonorrhea, causing cervicitis and vaginal discharge, is familiar to most sexual health doctors. What is less known, and where there is no clear indication at present, is whether this intermediate stage of endometritis is self-limiting. clinical condition and if so, how it should be diagnosed and treated. Endometritis is pathological diagnosis with normal infiltration vascular system inflammatory cells.

Endometrial sampling is usually done using an endometrial suction biopsy device, which is inserted through the cervix to obtain a small piece of endometrial tissue. This is generally a simple, well-tolerated procedure performed in outpatient setting. Unfortunately, fixation, staining and reporting of an endometrial sample takes several days, and even slight delays in confirming the diagnosis and initial therapy pelvic infection may have serious consequences for future fertility.

Inflammation of the uterine mucosa, both in acute and chronic forms of the disease, usually affects both layers of the endometrium. The most common inflammatory process is:

Diffuse (the entire mucous membrane is affected).
Ochagov.

In addition, chronic endometritis is often combined with inflammatory lesions of other structures of the female genital tract, such as the fallopian tubes. Also pathological process can spread to the deeper layers of the uterus (myometrium), changing the normal cellular structure of the uterine wall. All this ultimately leads to serious violations menstrual and reproductive function women.

This limits the clinical applicability of this approach for diagnosis, as well as theoretical risk introduction of infection into the upper genital tract when taking an endometrial biopsy. A quicker assessment of endometrial inflammation can be obtained by looking at a gram-stained smear or wet patch of vaginal discharge. An increase in the number of polymorphs in the discharge is associated with endometritis, although the correlation is not particularly strong. In other words, the absence of pus cells makes endometritis very unlikely, but their presence is not specific.

Therefore, the chronic course of endometritis can be characterized as immediate cause female infertility.

Reasons

The main causes of endometritis are infection in combination with certain risk factors. Inflammatory process can be caused by bacteria, viruses, fungi, protozoa and other infectious agents.

Other Features vaginal smear, such as a decrease in lactobacilli, may also support the diagnosis of endometritis, but have not been rigorously evaluated. Endometritis usually occurs in women who have otherwise had an uncomplicated lower genital tract infection. About a quarter of women with cervical gonorrhea or chlamydia will also have endometritis on endometrial biopsy, as will 15% of women with bacterial vaginosis. Predicting that women will have endometritis, as opposed to an infection limited to the lower genital tract, is difficult.

According to statistics, sexually transmitted infections (STIs) play a large role in the occurrence of endometritis. It is detected in more than 70% of cases. The most common STI pathogens are:

Gonococci.
Chlamydia.
Urea and mycoplasma.
Genital herpes virus.
Cytomegalovirus and others.

Also, the inflammatory process in the uterine cavity can be caused by opportunistic flora, the pathogenic properties of which are activated under the influence of various unfavorable factors. In this case, they play a big role anaerobic bacteria(bacteroides, coli, some types of streptococci and others.).

The presence of endometritis is not associated with behavioral or demographic characteristics such as age, ethnicity, condom use, or sex during menstruation. Use of oral birth control pills alone does not increase the risk of developing endometritis, but does appear to increase the risk of asymptomatic endometritis.

One of the few features that has been associated with endometritis is the phase of the menstrual cycle. This suggests that women are subjected to most at risk inflammation of the infection and cause inflammation of the endometrium only after their period, possibly due to loss of cervical mucosa or hormonal changes affecting the local immune function. This also raises the possibility that endometritis may, at least in a subgroup of women, be a temporary phenomenon with spontaneous clearance occurring over a period of several weeks.

In a significant number of cases of endometritis, an association of microorganisms is isolated, that is, the inflammatory process is caused by several infectious agents at once.

How does infection get into the uterus?

Main routes of penetration infectious agent into the uterine cavity are:

How to treat the disease in the acute phase?

Vaginal douching was associated with a higher incidence of endometritis, but only in those women who had recently douched or given a history of frequent douching. It has been suggested that douching "washes away" normal vaginal flora, increasing the risk bacterial vaginosis, which, in turn, predisposes to endometritis. Interestingly, the link between douching and endometritis is only observed in those who do not have bacterial vaginosis, which somewhat contradicts this theory.

Sexual. Special role plays an active role in the transfer of certain STI pathogens, such as chlamydia, by sperm.
Ascending (from the vagina through the cervix).

In a healthy woman, the uterine cavity is sterile. This condition is determined primarily by the normal function of the cervix, which is a barrier between aggressive external environment And internal structures female genital tract. If the cervical barrier is broken, the infection gains free access to the uterine cavity and other internal genital organs of the woman.

This highlights the difficulty of interpreting the relationship between infection upper sections genital tract and douching, since until recently the studies were all retrospective and therefore unable to explain cause and effect. Recently, suggestive data have been presented suggesting that women who are not at risk have more high risk infections of the upper genital tract than those who do not.

Acute endometritis: symptoms

Endometritis is associated with abdominal pain, as well as vaginal discharge, cervical tenderness and pyrexia, although at a lower rate than with salpingitis. Endometritis also leads to increased levels peripheral blood and erythrocyte sedimentation rate, which indicates its clinical significance. The presence of endometritis on endometrial biopsy correlates well, although not completely, with salpingitis - its positive and negative predictive values are about 90%.

In other cases, the infection can enter in the following ways:

Hemato- or lymphogenous (respectively, through blood or lymphatic vessels).
From nearby purulent foci along the peritoneum (for example, with appendicitis).

Sexual and ascending path infections are leading in the development of the disease and occur in more than 90% of women.
Thus, endometritis is usually associated with salpingitis, but can occur in isolation. Does endometritis require treatment? Nearly half of the patients in the study failed to clear their initial endometritis despite a good clinical response, and no correlation was found between the absence of endometrial inflammation and subsequent symptoms. In addition, the presence of endometritis at the initial diagnosis did not influence negative influence on subsequent long-term outcomes such as pregnancy, infertility and chronic pelvic pain.

Risk factors

Acute endometritis most often occurs after mechanical trauma to the endometrium or disruption of the cervical barrier. This occurs in postpartum period or after some medical procedures:

Curettage of the uterine cavity (diagnostic, for the purpose of abortion).
Hysteroscopy.
Introduction of an intrauterine contraceptive (“spiral”).
Probing of the uterine cavity.
Carrying out the in vitro fertilization procedure.

Endometritis after curettage of the uterine cavity or other diagnostic and treatment procedures may occur due to failure to comply with sterile conditions during the procedure.

Indeed, the trend was for endometritis to improve these outcomes. Endometritis can be defined based on histopathological appearance and appears to commonly occur in women with asymptomatic lower genital tract infections. Endometritis can be different clinical syndrome requiring treatment in those women who are symptomatic, but there is currently no evidence or against active screening and treatment asymptomatic women in the absence of infection of the lower genital tract.

The development of endometrial inflammation in the postpartum period is influenced primarily by the nature of childbirth. Thus, the risk of developing endometritis increases in the following conditions:

Delivery by caesarean section, application of obstetric forceps.
Bleeding.
Premature birth
Chorioamnionitis.
Injuries of the birth canal.
Manual examination of the uterine cavity (for example, in case of delayed separation of the placenta) and other pathologies.

In addition to direct mechanical impact on the uterine mucosa, and other factors are also related to the development of endometritis. These include:

A uterine infection is referred to in jargon as endometritis. It can spread to different layers of the organ and be taken seriously. Especially after childbirth, mothers are particularly vulnerable, so more attention needs to be paid. When in doubt, you should not wait too long to see a doctor.

Basics: Structure of the Uterus

To understand the condition of endometritis, you must first become more familiar with the anatomy of the uterus. The uterus is pear-shaped. It belongs to the female genital organs. The uterus consists of an overlying body and a short constriction called the isthmus. A narrowing separates the cervix from other parts of the uterus.

Extragenital diseases.
Hormonal imbalance.
Immunodeficiency states.
Endocrine diseases (especially diabetes mellitus).
Chronic inflammatory pathology.
Anomalies in the development of the genital organs.
Sexual behavior ( frequent change partners, neglect barrier means protection, sex during menstruation, etc.).
Prolonged stress, poor nutrition, physical overload, bad habits and others external influences, reducing immune resistance.

Chronic endometritis often develops as a result of inadequate treatment of an acute inflammatory process.

Symptoms of chronic course

The uterine wall is part of the body of the uterus and consists of the following layers. The symptoms that cause endometritis depend on the inflamed uterine lining. However, mild bleeding disorders, prolonged period and bleeding after intercourse are the first warning signs. When exposed to muscle layer myometrium, abdominal pain and sometimes fever occur. In these cases, the doctor speaks of myometritis. The uterine lining was called the gynecologist's perimeter.

Therefore, complaints often arise in vaginal area. These include, in particular, itching and unpleasant burning in the genital area. Another characteristic feature is a change in vaginal discharge, which usually smells and is yellowish-purulent in color.

Manifestations

Symptoms and treatment of endometritis directly depend on the phase of the inflammatory process (acute or chronic), as well as the root cause of the disease.

It is often possible to trace a direct connection between previous intrauterine intervention and the manifestations of the disease. Leftovers placental tissue, parts of the fetus (with incomplete abortion) serve beautiful nutrient medium for pathogenic bacteria and contribute to the development of inflammation in the uterus.

Causes and risk factors - How does a uterine infection develop?

If you notice any symptoms, contact your doctor as soon as possible. Uterine infection occurs whenever natural defense mechanisms organs are damaged. Accordingly, various triggers are taken into account. The most common causes are consequences of birth. Even after the labor process is complete, the cervix remains slightly open for the next six to eight weeks. During this phase of postpartum, bacteria more easily penetrate a woman's weakened body and cause inflammation.

Chronic endometritis is often diagnosed in women with miscarriage, a history of unsuccessful IVF attempts, and other pathologies. And it is sometimes simply impossible to establish the true duration of the disease.

Spicy

Symptoms of endometritis in women with it acute course usually develop a few days after infection. Acute endometritis is manifested by the following symptoms:

If the resulting endometritis remains untreated, it develops life-threatening turtle fever. In this case, the pathogens have spread through the bloodstream, so that it occurs with blood poisoning. Therefore, you should be careful when you notice nausea or similar symptoms in the postpartum period.

Especially in older women, hormonal change as a reason. Estrogen deficiency, as is common during menopause, negatively affects endometrial stability. It is less stable and therefore more susceptible to germs. In addition, the age of formation of uterine secretions decreases, so that another protective mechanism is weakened.

A sharp increase in body temperature, often up to high numbers (39–40 degrees).
Severe intoxication manifestations: increased heart rate, chills, weakness, headache etc.
Sharp pain in the lower abdomen.
Vaginal discharge with endometritis becomes sanguineous or purulent and has an unpleasant odor.
Frequent and painful urination is often observed.

Upon examination, the doctor reveals an enlarged and painful uterus, purulent discharge from cervical canal. Palpation of the lateral walls of the uterus also becomes painful, which is associated with damage to the lymphatic vessels.

Acute endometritis usually lasts up to ten days. If there is insufficient or ineffective treatment endometritis in this phase it becomes chronic.

Chronic

This form of the disease is sometimes called “sluggish endometritis,” which accurately characterizes its course. Signs of chronic endometritis are usually mild and, in most cases, are nonspecific.

Often there is an asymptomatic course of the disease, in which signs of endometritis can only be detected when additional methods examinations. In such women, the disease is often diagnosed already at the stage of complications (most often infertility).

Chronic endometritis is most often characterized by the following symptoms:

Periodic or permanent painful sensations in the lower abdomen (sometimes in the lower back).
Pathological vaginal discharge which are mucopurulent or serous in nature.
Menstrual irregularities. Uterine bleeding, intermenstrual bleeding is common spotting, prolonged and/or heavy menstruation.
Discomfort or even pain during sexual intercourse.

Chronic endometritis is not accompanied by an increase in body temperature, manifestations of intoxication and other symptoms characteristic of the acute phase. And the above signs of endometritis may be mild or absent altogether. This fact greatly complicates the timely diagnosis and treatment of chronic endometritis.

Diagnostics

Correct and timely diagnosis significantly increases the success of treatment of endometritis in women. The following methods are used for this:

Anamnesis collection. In most cases, the onset of the disease is preceded by intrauterine interventions, childbirth (especially pathological), insertion of an IUD, etc.
General clinical and gynecological examination.
Ultrasound scanning using Dopplerography (usually performed at the beginning and end of the menstrual cycle).
Endometrial biopsy or diagnostic curettage with obligatory follow-up histological examination the received material.
Hysteroscopy.
Detection of an infectious pathogen (bacteriological, bacterioscopic method, ELISA, PCR, etc.).

Usually, all these measures are carried out in a comprehensive manner, which makes it possible to more accurately establish a diagnosis and find out how to treat uterine endometritis.

Endometritis on ultrasound is characterized by an enlargement of the uterus, pronounced changes in the thickness of the endometrium, and unevenness of its contours. Areas of varying echogenicity and density are noted.

In addition, echo signs of chronic endometritis often include the identification of gas bubbles in the uterine cavity and its expansion, clear hyperechoic inclusions in the endometrium (calcifications) and other symptoms.

Instrumental examination (biopsy, hysteroscopy, uterine curettage) is usually carried out in the first phase of the cycle for diagnostic purposes chronic course diseases. Based on the histological conclusion, it is determined morphological changes endometrium, active or inactive endometritis, etc.

Treatment

Treatment of inflammatory lesions of the endometrium is a rather difficult task. Acute endometritis requires urgent hospitalization and treatment in a hospital setting. In the chronic course of the disease, therapy is carried out on an outpatient basis.

How to cure endometritis? First of all, you should carefully follow all doctor’s orders. For example, an incomplete course antibacterial therapy often a major factor in transition acute form diseases into chronic ones.

Basic principles of treatment:

Antibacterial therapy. Antibiotics for endometritis are always used, taking into account the infectious and inflammatory genesis of the disease. Such drugs are prescribed taking into account the sensitivity of the isolated microflora. Typically, cephalosporins, semisynthetic penicillins, aminoglycosides and other groups of antibacterial drugs are used.
It is necessary to prescribe agents that affect the anaerobic flora (for example, metronidazole).
Drugs with detoxifying and immunomodulatory effects.
Local drugs ( vaginal suppositories with antibiotics and metronidazole).
Non-steroidal anti-inflammatory drugs.
Prevention of dysbacteriosis - antifungal drugs.
Surgical treatment for acute endometritis (removal of remnants ovum, placental tissue, etc.) is carried out only against the background of massive antibacterial therapy.

In order to completely cure endometritis, they are successfully used various methods physiotherapeutic effects, sanatorium-resort treatment. IN acute phase Physiotherapy for endometritis should be used only after the inflammatory manifestations have subsided.

Chronic

Considering the “insidious” course of this disease, the natural question is: is it possible to cure chronic inflammation of the endometrium?

The treatment regimen for chronic endometritis is determined only by the attending physician. In this case, morphological changes in the structure of the endometrium, the presence of synechiae in the uterine cavity and associated disorders must be taken into account. reproductive system women. Therefore, it is possible to cure chronic endometritis only with integrated approach to therapy, and the patient’s compliance with all doctor’s prescriptions.

Treatment chronic inflammation In most cases, the endometrium is performed in several stages. The goals of such therapy are:

Elimination of bacterial or viral factors that damage the endometrium.
Recovery normal function damaged endometrium.

At the first stage, antibacterial or antiviral drugs taking into account the identified infectious pathogen. If it is impossible to determine the type of microbe, then so-called empirical antibiotic therapy is used. wide range actions. Antibacterial drugs used both systemically and locally (by introduction into the uterine cavity).

Restoring the impaired function of the uterine mucosa takes quite a long time. The following treatment methods are usually used:

Enzyme therapy.
General strengthening drugs, vitamins, immunostimulants, etc.
Desensitizing therapy.
Physiotherapy - exposure to magnetic fields, electrophoresis, UHF, ultrasound, infrared rays, etc.
Mud therapy and balneotherapy (baths, irrigation).
Surgical intervention is used only in the presence of synechiae (adhesions or adhesions) in the uterine cavity.

If the menstrual function are appointed hormonal drugs, for example, combined oral contraceptives or single drugs (estrogens, progesterone).

Consequences

The inflammatory process in the mucous membrane of the uterus, especially if it lasts for a long time, can provoke the development serious complications. These include:

Spreading infectious process to other structures of the female genital tract.
Infertility.
Increased risk of ectopic pregnancy.
Miscarriage.
Pathology of placenta attachment.
Complicated pregnancy: placental dysfunction, fetal hypoxia, etc.
Premature birth.
Infection of the fetus and newborn.
Stillbirth.
Autoimmune pathology.
Menstrual irregularities, uterine bleeding.
Antiphospholipid syndrome.
Chronic pelvic pain syndrome.
Adhesive processes in the uterine cavity (Asherman's syndrome).
Leiomyoma of the uterus.
Endometriosis.
Dyspareunia (pain during sexual intercourse) and other disorders.

Prevention of development inflammatory lesions The endometrium is not complicated. It consists, first of all, in compliance elementary rules sexual hygiene (regular sexual partner, use of barrier methods to protect against sexually transmitted infections). It is also important to regularly visit a gynecologist for early detection and treatment of hidden infections of the female genital tract.

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Endometritis - main symptoms:

What is endometritis? This is a disease characterized by an inflammatory process in the uterine mucosa. This process does not affect the muscle layer of the affected organ. Very often this disease is confused with metroendometritis, although these are completely two various diseases. In the second option, the prognosis is much sadder, because after suffering metroendometritis it is not always possible to get pregnant.

Reasons

The root cause of the formation of the disease is damage to the mucous membrane of the uterus, which contributes to the formation of the inflammatory process. But such a pathology in itself cannot provoke endometritis. Important role Reduced immunity and non-compliance with sanitary standards when performing manipulations play a role in this process. In addition, the following common reasons are identified:

curettage of the uterine cavity;
probing the uterine cavity;
hysterosalpingography;
endoscopic diagnosis of the uterine cavity;
installation of intrauterine contraceptives;
inaccurate douching.

Today, postpartum endometritis has become of particular importance. They are associated with perestroika immune system female body. The inflammatory process very quickly affects the muscular layer of the uterus and serves dangerous complication postpartum period.

Endometritis is a polyetiological disease, the occurrence of which is influenced by many pathogens:

group B streptococci;
coli;
Klebsiella;
enterobacter;
Proteus;
chlamydia;
mycoplasma;
diphtheria bacillus;
Mycobacterium tuberculosis.

Chronic endometritis occurs due to improper treatment of acute endometritis, as well as when the infection settles in the tissues for a long time. The causative agents of the disease can be the ones listed above.

How does the disease manifest itself?

The symptoms of endometritis are not pronounced, so a woman may not immediately detect them. This phenomenon contributes to the development of inflammation in severe form, as a result of which it affects the muscle layer of the organ. This situation requires immediate hospitalization and inpatient treatment.

A timely visit to the doctor will allow timely treatment of endometritis and avoid its transition to metroendometritis.

There are chronic and acute endometritis. If diagnosis and treatment of acute endometritis is not particularly difficult, then chronic form causes many difficulties. This is another factor that requires careful diagnosis if symptoms of endometritis occur.

Manifestations of acute disease

Acute endometritis occurs due to artificial termination of pregnancy. In most cases, this occurs due to failure to comply with all necessary sanitary standards. Acute endometritis manifests itself as follows:

increase in body temperature to 38–39° C;
the occurrence of serous and bloody-purulent discharge from the vagina;
pain in the abdomen extending to the sacrum;
general malaise.

In the current situation it is necessary immediate help specialist and it is forbidden to self-medicate, since acute endometritis is inflammatory disease, so it can affect various tissues located close to the primary focus.

By delaying going to the doctor, every woman increases the risk of severe purulent-septic complications that require careful treatment. The result of this kind of complications will be sepsis with a fatal outcome.

Manifestations of chronic disease

Chronic endometritis has almost the same symptoms as acute endometritis. The manifestations in this case are blurred. Chronic endometritis manifests itself as follows:

Elevated body temperature that lasts for a long time.
Irregular bleeding from the uterus. This process is also typical for healthy women, but blood cells are invisible in the secretions. Factors that contribute to the formation of uterine bleeding include decreased contractile activity genital organ and impaired platelet aggregation properties.
Vaginal discharge that is putrid in nature.
Painful sensations during bowel movements.

Chronic endometritis and pregnancy are compatible concepts? As a rule, such a disease does not prevent conception, which occurs during ovulation. It’s another matter when chronic endometritis is combined with other genital pathologies. In this case, you can get pregnant, but most often this leads to spontaneous miscarriages.

Endometritis and childbearing

Endometritis and pregnancy - these words really frighten many women who decide to become mothers? You can get pregnant, but only if treatment was started on time and no complications arose. Although it is impossible to say for sure here. Many doctors on the issue of pregnancy and endometritis are inclined to believe that it will be impossible to conceive and carry a baby, since this disease causes adhesions leading to infertility. As practice shows, during pregnancy and endometritis, this disease does not affect the functioning of the ovaries, but the issue of implantation of the embryo and its further gestation remains relevant.

Most patients refuse to take antibiotics and this is completely in vain, since it will be much more difficult to conceive a baby, and even more so to carry him to term. You can take antibiotics even during pregnancy, since pregnancy after treatment of acute or chronic endometritis will last until the end of the term without pathologies for the child.

Diagnostic test

Diagnosis of the presented disease should begin with the doctor carefully listening to all the patient’s complaints. There are situations when a diagnosis can be made based on the manifestations of acute endometritis. However, to confirm the disease, the doctor must perform next row actions:

Perform a physical examination of the woman gynecological chair. Such a diagnosis will allow him to evaluate the discharge present: color, smell and quantity.
Take swabs and send them for examination. The results of the smears will help you find out about the presence of endometritis pathogens. The doctor takes swabs for culture for more precise definition the nature of the pathogen and its reaction to certain drugs.
General blood test.
Ultrasound of the uterus. Such a study is prescribed if necessary. Using ultrasound, you can detect compactions of the mucous membrane, characteristic blood and purulent clots and affected fallopian tubes, ovaries.

Therapy

Once the diagnosis has been made, you can proceed to treatment of endometritis. It is the gynecologist who, based on the test results obtained, will be able to draw up an effective treatment regimen.

Endometritis and pregnancy may not depend on each other if therapeutic measures were started on time and there were no complications. Treatment of endometritis should take place in outpatient under the strict guidance of the attending physician. The therapy regimen provides the following action plan:

antibacterial drugs;
antibiotics;
mechanical cleaning of the uterine cavity;
cleaning plasma from harmful toxins and bacteria.

How to treat the disease in the acute phase?

With early diagnosis of acute endometritis and modern therapy You can prevent all complications and get pregnant safely. Acute endometritis can be treated with the following action plan:

Immunomodulators and vitamins.
Antibiotics. The following drugs are prescribed: Metril in combination with Cephalosporins intravenously. The course of therapy is 5–10 days.
If after an abortion the remains of the fetus or placenta are found, then it is advisable to re-curettage the uterine cavity.
Treatment of endometritis with physiotherapeutic methods.

How to treat the disease in the chronic phase?

Chronic endometritis has its own symptoms that differ from the acute form. Therefore, the treatment of chronic endometritis consists of stopping the specific causative agent of the disease.

First of all, the doctor must take swabs for culture and check susceptibility a certain type pathogen to various antibiotic drugs. After this, he will be able to draw up a specific treatment regimen for chronic endometritis. Next is assigned efficient scheme therapy, including joint reception antibiotics and antiviral drugs.

The most effective treatment chronic endometritis is an input medicinal drugs into the lining of the uterus. This approach promotes the concentration of the maximum amount medicines at the site of inflammation. In addition to the above, the following therapeutic methods are used to treat chronic endometritis:

Hormonal therapy. Oral contraceptives are used here. Such activities should be carried out when a woman dreams of pregnancy and chronic endometritis will not be a hindrance to her.
Separation of formed adhesions by surgical method.
Physiotherapy for the treatment of chronic endometritis. If the patient’s condition has returned to normal, then it is advisable to use physiotherapeutic methods of therapy. They increase the outflow of mucus and pus from the uterine cavity, and also improve local reparative functions.

Therapy for purulent endometritis

Treatment of chronic purulent endometritis includes mechanical cleaning of dead tissue and pus of the uterine cavity. This manipulation is characterized unpleasant sensations, so they perform it under general anesthesia. After this, hormonal medications are prescribed.

Postpartum endometritis occurs after unsuccessful removal of the placenta after delivery. Therapy for this form of the disease includes taking antibacterial medications. The treatment regimen is compiled individually for each breastfeeding woman. Timely diagnosed postpartum endometritis does not require a rehabilitation course. In order for postpartum endometritis to disappear, you must always be under the supervision of a doctor and follow all his instructions.

Preventive methods

If there is a possibility that postpartum endometritis will form, then prevention includes taking antibacterial medications. Prevention after therapy is based on compliance with all sanitary standards during uterine bleeding, abortions, childbirth. Required condition is a regular visit to the gynecologist, who could promptly identify all pathologies. To protect yourself from exacerbations of endometritis, you need to constantly strengthen your immunity.

Endometritis is dangerous female disease, which most often occurs due to failure to comply with sanitary standards during such manipulations as childbirth and abortion. Characteristic symptoms pathologies are purulent discharge from the genitals and increased temperature. Treatment of the disease is selected individually, taking into account the form of the disease: chronic or acute.

If you think you have symptoms characteristic of this disease, your doctor can help you