Endometritis – colloquially called uterine inflammation – (endometritis; ancient Greek ἔνδο(ν) éndo(n), German “inside” and ancient Greek μήτρα mḗtrā, German “uterus“; ICD-10-GM N71.-: Inflammatory disease of the uterus, excluding the cervix/cervix) is inflammation of the lining of the uterus (endometrium), with involvement of the myometrium (layer of the wall of the uterus consisting of smooth muscle)-endomyometritis, metritis (inflammation of the muscular layer of the uterus) and perimetrial perimetritis (spread of myometritis to the perimetrium, the space around the uterus). The disease is rare in isolation and usually asymptomatic.
Forms of the disease:
- Acute, subacute, chronic endometritis.
- Purulent (purulent, abscessing) endometritis (pyometra (purulent inflammation of the uterus), uterine abscess).
- Hemorrhagic endometritis
- Nonpuerperal (“not occurring in the puerperium”) endometritis:
- Nonspecific endometritis: typical pathogens: chlamydia, staphylococci, streptococci, Escherichia coli, anaerobic bacteria.
- Specific endometritis: endometritis gonorrhoica, endometritis tuberculosa, endometritis post abortum, endometritis senilis, iatrogenic (caused by medical procedures) endometritis after intrauterine procedures e.g. Abortion, diagnostic curettage (scraping), diagnostic or therapeutic hysteroscopy (endometrial endoscopy), endometritis caused by foreign bodies (lying intrauterine device, IUD), endometritis caused by tumors e.g. polyps, myomas (benign muscular tumor), carcinomas.
- Puerperal endometritis (puerperal fever, puerperal fever / childbed fever).
Frequency peak: the maximum incidence of endometritis is between the ages of 15 and 30 years.The prevalence (frequency of disease) is not known because of the rarity and lack of symptoms.
The incidence (frequency of new cases) of puerperal endometritis (puerperal fever) is approximately 0.2-3% in Europe and North America. It is <1% for vaginal delivery. The risk after sectio is up to 20 times higher. It also depends on whether antibiotic prophylaxis was given or not. The incidence rate of all other endometritides is not known.
Course and prognosis: The course and prognosis of endometritis are good. Complications such as pelveoperitonitis (peritonitis confined to the lesser pelvis), tuboovarian abscess (encapsulated focus of inflammation involving and caking the fallopian tube and ovary), or sepsis (blood poisoning) can be problematic. Even puerperal fever, which used to be so feared, can generally be well controlled by combined antibiotic administration. The lethality (mortality related to the total number of people suffering from the disease) is practically zero today. Exceptions are: Sepsis and endotoxin shock (toxic shock syndrome, TSS; synonym: tampon disease) caused by group A streptococci and staphylococci. They are extremely dangerous and rank third in maternal mortality (number of deaths in a given period, based on the number of the population in question) after hemorrhage and thromboembolism. The lethality is approximately 30% for staphylococcal TSS and 5% for streptococcal TSS.
