Inflammation of the uterus in the puerperium (Endo(myo)metritis puerperalis) | Postpartum diseases

Inflammation of the uterus in the puerperium (Endo(myo)metritis puerperalis)

Inflammation of the uterus in the postpartum is usually caused by ascending infections from the vagina. The reasons for this can be a congestion of the puerperium, premature rupture of the bladder, frequent vaginal examinations (possibly without prior disinfection of the genital area), delayed uterine regression (uterine subinvolution) and a long birth process. In rare cases, inflammation of the fallopian tubes and ovaries (adnexditis) may occur.Even more rarely, since the introduction of antibiotics a rarity, blood poisoning (sepsis puerperalis) can occur as a result of carried pathogens or pathogens that enter the bloodstream.

In the past, this was a common reason for the death of mothers after birth. Symptoms include increased temperatures, possibly fever attacks, abdominal pain and reduced, bad-smelling postpartum flow. Sepsis is characterized by very high fever, chills, enlargement of the spleen (splenomegaly) and an increased heart rate (tachycardia). The symptoms can worsen and lead to death if no therapy is initiated.

Inflammation of the mammary gland in the puerperium (mastitis puerperalis)

Through small cracks and wounds on the nipples, which often occur when the wrong breastfeeding technique is used, pathogens can penetrate and lead to inflammation of the mammary gland (mastitis). The breast becomes red, hot, thick and painful (pressure dolent). There is also fever, possibly chills. In the initial stage, moist compresses (quark compresses) are sufficient for relief, in the advanced stage, treatment with antibiotics is necessary. If no treatment is given, abscesses (pus cavities) will develop in the further course of the disease, which then require surgical opening.

Milk congestion

Further information can be found here: Milk congestion – what can you do? A few days after birth, milk production in the mother’s breast is stimulated very strongly so that there is enough milk available for the newborn baby. However, if the baby does not empty some parts of the breast, milk will remain behind and the constant new production can lead to a milk congestion.

As a result, the otherwise very soft breast tissue hardens and is often very sensitive to pain. Especially the sucking of the baby is a great pain stimulus. Milk congestion usually occurs in the first few weeks after birth, but can in principle cause problems during the entire breastfeeding period.

The cause of milk congestion can be excessive milk production, which exceeds the newborn’s drinking needs. A change in the baby’s drinking rhythm or a bra that is too small and too tight can also lead to milk congestion. If the milk congestion is not treated, it can develop into mastitis puerperalis. The best treatment for milk congestion is to let the baby continue to drink despite the pain in the breast, so that the breast is relieved and as much milk as possible comes out. Special techniques should be discussed with the midwife in order to optimize breastfeeding and increase the newborn’s drinking volume if it is too low.