View source for Postpartum endometritis

''For endometritis unrelated to pregnancy, see [[Pelvic inflammatory disease (PID)]].''

==Background<ref>Stevens DL and Bryant A.  Pregnancy-related group A streptococcal infection.</ref>==
*Any postpartum woman with fever should be assumed to have a genital tract infection
*Postpartum women have a 20-fold increase in invasive group A streptococcal infection compared with nonpregnant women.
*Most often polymicrobial, requiring broad spectrum antibiotics
*Maternal mortality is highest if infection develops within 4 days of delivery

===Risk Factors===
*Cesarean delivery (most important)
*Prolonged labor
*Prolonged or premature rupture of membranes
*Internal fetal or uterine monitoring
*Large amount of meconium in amniotic fluid
*Manual removal of placenta
*[[Diabetes Mellitus]]
*[[preterm delivery|Preterm birth]]
*[[Bacterial vaginosis]]
*Operative vaginal delivery
*Post-term pregnancy
*[[HIV]] infection
*Colonization with [[Group B Strep]]

==Clinical Features==
*[[Fever]]
*Foul-smelling [[vaginal discharge|lochia]]
*[[Leukocytosis]]
*Uterine tenderness
*Only scant discharge may be present (esp with [[group B strep]])

==Differential Diagnosis==
*Respiratory tract infection
*[[UTI]]/urosepsis
*[[Pyelonephritis]]
*Intra-abdominal abscess
*[[Thrombophlebitis]]

{{Postpartum emergencies DDX}}

==Evaluation==
*Evaluate for [[retained products of conception]] (e.g. [[pelvic ultrasound]])

==Management==
===[[Antibiotics]]===
{{Endometritis Antibiotics}}

==Disposition==
*Consult OB/GYN first if are considering outpatient management
*Admit all patients who appear ill, have had a C-section, or underlying comorbid conditions

==See Also==
*[[Post-Partum Emergencies]]

==References==
<references/>

[[Category:OBGYN]]
[[Category:ID]]