Causes of exacerbation of chronic endometritis. Diagnosis of chronic inflammation of the uterus. Hysteroscopy or hysterosalpingography

The inflammatory process is called the uterus cavity, or rather, the endometrium is localized on the surface layer. The penetration of inflammation in deeper fabrics, like the myometrium or the basal layer of the endometrium, is carried out about endomyometritis. Often, an endometritis feature becomes the transition of an uptaking infection to the uterine pipes.

When endometritis, functional and basal layers of the mucus of the uterus are affected. The inflammatory process can distribute to the entire mucous membrane or wearing focal nature. With severe endometritis, the muscular layer is involved in the process, the defeat of which can also be diffuse and focal.

To the reasons for the occurrence of endometritis First of all, pathogenic or conditionally pathogenic microflora, penetrating so deeply as in the uterus. One way or another, the endometritis is based on bacterial vaginosis, that is, a violation of the microflora of the internal genital organs, as a result of which the propagation and distribution of dangerous bacteria occurs. Endometritis can be preceded by such inflammatory diseases as vulvit, vaginitis, cervicitis, as well as incorrect maintenance or complications of childbirth, abortions or other intrauterine interventions, as a result of which pathogenic microorganisms can penetrate. The same sexual acts in the period of menstruation (with ascending infection) and the uncontrolled use of intrauterine spirals.

To microorganisms, mainly speakers, endometritis attributes include:

streptococci
staphylococci
gonokokki
chlamydia
mycoplasma,
ureaplasma
less frequently pathogenic anaeros and excmunicate-whether bacterial vaginosis Prevotella SPP., Peptostreptococus SPP., Gardnerella vaginalis,
more about Haemophilus Influenzae, Streptococcus Pneumoniae.

Depending on the characteristics of the flow and clinical symptoms, they distinguish with acute and chronic endometritis. The clinical appearances of acute inflammation are 3-4 days after the infection in the uterus cavity. The patient has:

increasing body temperature;
pains of the abdomen and in the inguinal areas;
mucous-purulent liquid allocations, sometimes with an unpleasant odor,
bloody issues In case the epithelial cover of the endometrium is subjected to desquamations, that is, rejection;
hyperpolymenorrhea - violation menstrual cyclemanifested by the gain of bleeding and an increase in its duration, usually against the background of all the same deskvamation of endometrial.

Chronic endometrite develops against the background of acute, is a consequence of its inadequate treatment. It is characterized by frequent relapses and violation of the female reproductive function. Distinctive features Chronic endometritis doctors gynecologists call:

endometrial hyperemia;
partial necrosis endometrial;
a decrease in the number of vaginal discharges, however, they are involved in the mystery-purulent nature;
body temperature is normalized;
menstrual cycle disorder is likely - menorragia or metroralragia against the background of diskvamation processes and reparations of en-domometria, as well as the contractile function of the uterus;
pains are preserved in the bottom of the alive, lower back and the sacrum,
vaginal examination indicates an increased, compacted and painful uterus.

How to treat endometritis?

Treatment of endometritis It is determined by its shape, acute it or chronic. Common for both of them is the need complex therapyaimed at overcoming painful symptoms and, of course, to eliminate the causes of the disease.

Acute endometrite Requires the following events:

bed mode;
cold on the bottom of the abdomen;
reception of antibiotics - accurate names and dosage determines the attending physician, focusing on the severity of the process, its origin, the duration of the disease;
reception of non-steroidal anti-inflammatory means - sedative, desensitizing, specifically again determines the specialist;
reception of immunostimulants and immunomodulators;
if necessary, in particular with an increased blood loss, hemostatic agents and means increasing the contractile disposal of the uterus are prescribed;
probably use of the flow drainage of the uterine cavity with cooled antiseptic solutions;
if necessary, removal from the uterus of substrates provoking or supporting inflammation (for example, residues fruit egg or decidual fabric); The event is appointed a few days after active phase Antibacterial or infusion therapy, with stabilized body temperature.

Treatment of chronic endometritis involves a combination of biological, pharmacological, physical, and sometimes balneotherapeutic methods. The antibiotics of a wide range of action are shown during menstruation, if uterine bleeding is developing, it is important to take without symptomatic hemostatic therapy. The need to install into the cavity of the uterus of antiseptic means is not excluded.

Physobalnetoperapy is prescribed to improve hemodynamic processes in the organs of the small pelvis, the stimulation of the hypofunction of ovaries and endometrial, as well as to increase the immunological properties of the body. This task is performed using the physical factors - microwaves of centimeter band, UHF, ultrasound in pulse mode, electro-roforesis of copper or zinc; In addition, therapeutic dirt, ozokerite, paraffin, radon baths and irrigation are appropriate.

In completion or in parallel with the main treatment, vitamins, desesensibizers and immunomodulators are prescribed.

What diseases may be connected

Endometritis is extremely rarely developing as an independent disease. It is typically, as its basis, it contains less complex diseases, since it is usually provoked by the pathogenic microflora, which causes anxiety not only the uterus, but also closely external environment Having authorities:

vulvit - inflammation of female external genital organs, vulva;
- inflammation of the mucous membrane of the vagina;
- inflammation of one or both phallopy pipes;
- inflammation of the phallopyan pipe in combination with the inflammation of the ovary;
- inflammation of the cervix;
- Inflammation of the mucous membrane of the cervix.

the condition necessarily accompanying any endometrite is. This is the name of the condition developing on the background of substitution of normal for vaginal flora lactobacilli-pathogenic anaerobic microorganisms.

The most dangerous complication of endometritis is referred to since the damaged endometrium cannot become a favorable soil for the observance of the fertilized egg. In addition, most of the endometrite is accompanied, and in particularly dangerous cases.

Treatment of endometritis at home

Treatment of endometritis It is produced mainly at home, if there are no special testimony to hospitalize the patient. For example, under the constant control of doctors, endometritis therapy can be carried out in pregnant women, however, during pregnancy, the disease is so undesirable, which is important to carry out its prevention, in order not to do treatment.

Treatment of endometritis At home involves compliance bed regime, strict adherence All medical prescriptions and a visit to the gynecological office to control the therapy produced. Visit medical institution It may also be necessary for conducting physiotherapeutic or balneotherapeutic procedures. Folk methods can be used in the case when the attending physician does not object and aware of the selected recipe. Self-treatment is contraindicated and dangerous serious complications.

What drugs are treated endometritis?

Examples of antibacterial drugs can be:

- the dosage and duration of the course of treatment determines the attending physician, focusing on the severity of the disease and the type of pathogen; Probably assign analogues;
- the dosage and duration of the course of treatment determines the treasured doctor; Probably assign analogues;

Examples of NSPIDs can be:

- 10 mg to 4 times a day depending on the severity of pain;
- 100 mg twice a day.

As sedative preparations can be applicable tincture of a dying or Valerina extract.

Treatment of endometritis by folk methods

Folk remedies for the treatment of endometritis - it is predominantly grain ragners, favorably affecting women Health. Such decoctions are accepted orally, usually courses at 21 days, often after 7-10 days, a retur-course is advisable. The recipe and feasibility of application must be discussed with its attending physician, you can stop the choice on one of the following recipes:

connect in equal proportions of the root of Levzei and Altea, grass, lavender, lavender, donel, dryers and nettle, sheet of blueberries, pine buds; Carefully grind, 2 tbsp. Gathering to put in a thermos, pour ½ liter of boiling water, insisted overnight, strain; Take several courses for two months by ¼ glass, up to 3-4 times per day;
connect in an equal proportion of grass Highland sweating, chicory, chablie, calendula flowers, coltsfoot, Tocureans, Dyagil and Dandelion, Badan root; Carefully grind, 2 tbsp. Gathering to put in a thermos, pour ½ liter of boiling water, insisted overnight, strain; Take several courses for two months to 1/3 cups, up to 3-4 times per day;
connect in equal proportions of the grass of rubbish, shepherd bags, mint, mother-in-law, viburnum, bark viburnum, cuff leaf, chamomile flowers, radiol root; Carefully grind, 2 tbsp. Gathering to put in a thermos, pour ½ liter of boiling water, insisted overnight, strain; Take several courses for two months to 1/3 cups, up to 3-4 times per day;
connect 1 tsp. A spoon of coriander fruits and grass wormwood bitter, colors of riots of ordinary and grass geranium, add 2 s.l. Flowers of the labar of the viscousiste; components thoroughly crushed; 3 tbsp. collection to pour 650 ml of boiling water, put on a slow fire and withstand 25-30 minutes; When the decoction will cool, strain; Take ½ cup 3-4 times a day;
1 tbsp. Herbelchoe herbs pour a glass of boiling water and to withstand 10-15 minutes in a water bath, remove from the fire, leave to appear to half an hour, strain; Take on the ¼ cup three times a day;
grind in meat grinder or blender 1 tsp. chopped onion, ½ lemon and orange (with peel), add 1 tbsp. Sugar, mix thoroughly; Take 1 tsp. Three times a day for at least one week.

Folk Medicine offers tools for local applications:

oil tampons - based on sea buckthorn oil, 8-10 days course, use tampon overnight;
appliques from Propolis - based on a 30% alcohol solution of propolis, a course of 14 days, put applications at night.

Treatment of endometritis during pregnancy

During pregnancy, it is important to treat our body and the health of the urogenital system in particular to prevent the development of endometritis. Often endometrite becomes a consequence generic activityHowever, and this manages to avoid, if you carefully treat your well-being and not postpone the visit to the gynecologist in the event of restless symptoms, as well as on scheduled inspections.

The presence of endometritis, in particular, chronic, is considered a factor with a reference to the pregnancy, but its completely successful exodus never excludes. The doctor's planning doctors admit only after complete elimination of acute endometritis. If the disease gained a chronic form, the forecast for a favorable current pregnancy is smaller, but not minimal.

With the first difficulties, a woman may come back at the stage of conception, but chronic endometritis and the occurrence of pregnancy are not mutually exclusive concepts. If it is responsible to approach the occurrence of pregnancy and pass a full course of treatment, incl. Adequate antibacterial therapy, then the chances of pregnancy and tooling the child are significantly increasing.

If pregnancy develops against the background of an incident endometritis, it is paramount to identify pathology as possible on an earlier period. In this case, drug therapy is carried out with minimal risks for the future kid. Preparations are chosen by a professional physician, taking into account the fact that the expected therapeutic effect exceeds a possible negative effect on the fruit and child.

What doctors to contact, if you have endometritis

Diagnosis of endometritis includes a wide range of procedures, since the disease is very complex and is based on its often deep pathogenesis. It is on the history of the violation that the doctor draws primary attention to the doctor, in this context it is important to establish if the place of intrauterine interventions, necrosis of the sublifted node, etc. circumstances. Then an objective and gynecological study is carried out, in the framework of bacteriological research of the contents of the uterine cavity, the microbial flora is determined, the pathogens in the cervical canal are revealed by the PCR method.

The acute endometrite in the gynecological examination indicates several uve-defined, pastose, painful during palpation, especially on the sides and in the course of large lymph vessels of the uterus. With the rapidness of the pelvic peritoneum, soreness appears when the cervical shift appears (this is due to the tension of the inflamed peritoneum).

In parallel with the fact that it may be advisable to appoint an ultrasound of the organs of a small pelvis - to determine the magnitude of the uterus, the thickness of M-echo, detecting tubarial abscesses. Diagnostic laparoscopy allows you to ensure the opportunity to assess the appendages of the uterus and eliminate other surgical pathologies. Among other things, the biopsy of the endometrium is prescribed. These diagnostic methods are applied with respect to acute endometritis.

Suspicions of chronic endometrite arise, respectively, on the basis of anamnesis, pointing to the transfer of acute endometritis, and at the time of the examination the patient is experiencing a very obvious symptoms of the chronic process - pain at the bottom of the same, in the lower back and the sacrum, increasing and painfulness of the uterus, mucous-purulent and disruption of the menstrual cycle; The latter is associated with a violation of the processes of desquamation and repair of the en-domometric and the contractile function of the uterus. Moisture-loving research indicates an increase, compacon and soreness of the uterus, endometrium is hyperemic, and sometimes necrotized.

During the exacerbation of chronic or at the active stage of acute endometritis, the blood test shows the leukocytosis, the leukocyte glue shift is noted, accelerating the erythrocyte sedimentation rate. The acute stage of the endometritis will continue 8-10 days, after which, with adequate treatment, the process of inflammation ends, and with inadequate it turns into a subacute or chron-nic form.

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Information is intended solely for educational purposes. Do not self-medicate; For all issues relating to the definition of the disease and the methods of its treatment, please contact the doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal.

Endometritis is inflammation of the uterus mucosa (endometrial). This disease may have an acute or chronic form. Chronic form is heavier, as its treatment takes longer.

Endometrite develops in cases where bacteria living in the vagina are transferred to the uterus - it can be chlamydia, streptococci, gonococci and other microorganisms. If the integrity of the mucous membrane of the uterus is broken, the infection affects its tissue, which leads to an inflammatory process. This happens, first of all, in the course of various procedures and gynecological studies after delivery (if pregnancy was problematic) or miscarriage.

The leader in the fight against all female (and not only female) infections and inflammation is garlic. Therefore, garlic tampons bring a stunning result after two to three procedures. Women who do not come long-awaited pregnancymust necessarily undergo a course of treatment with garlic tampons. To do this, the clove must be cleaned from the skins, cut into several places (so that the juice stood), to dip in any oil or fat, wrap in the gauze and enter the vagina overnight. Ideally, you need to make garlic tampons 10 nights in a row. After such therapy in inflammation in the organs of the small pelvis, the monthly will become less long and less painful.
Additionally, you can make tampons with sea \u200b\u200bbuckthorn oil. They do not struggle with infections, but they will accelerate the healing of the damaged mucous membrane of the uterus. First, go through the course of garlic tampons, and then make some sea buckle oil procedures. By the way, this tool has no contraindications - even pregnancy is not a reason for the failure of sea buckthorn oil.
A good effect is given tampons based on the plantain. For this fresh leaves Plants need to wash, scream with boiling water, grind and mix with little butter. Take this mixture to gauze and enter the vagina overnight. Additionally, use other folk remedies from endometritis.

Drawing a decoction of oak leaves

Try to accelerate the treatment process with douching. With inflammation, the greatest benefits will be brought with decoction oak leaves. For this, the handful of plants need to be slapped in a liter of water about half an hour (on a small fire), then cool to a temperature of 40s, strain and apply for scrusts. Repeat the procedure several times a day for one or two weeks.

Wine, relieving inflammation in female genital organs

With any chronic inflammation in the bodies of the small pelvis (including endometritis), wine is still successful for herbs. To make it cooking you need to take 50 g of the shepherd bags, 50 g of clarity and 50 g of the leaf of the Chernobyl. Put these herbs in glass jar and pour a liter of high-quality white wine. Mixture insist 10 days away from sunlight, then strain and store in the refrigerator. Take on a tablespoon of medicine three times a day. Treatment lasts until the inflammatory process disappears.

Herbal fees

Herbal fees act at once in several directions: destroy the infection, relieve inflammation and restore the integrity of the mucous membrane of the uterus. This effect is achieved by applying several medical herbs. See what fees can be used in chronic endometritis:

The cort is crash - 15 g;
Blackberry leaves - 15g;
Birch leaves - 15g;
Drore flowers - 15 g;
Mint leaves - 15 g;
Thousands of yarrow - 15 g;
Valerian root - 15 g.

Obtaining and use: 1 tablespoon of herbal mixture is poured with two and a half glasses of boiling water, boiled for 10 minutes, then tomatoes under the lid for 15 to 20 minutes. The fluid decoction needs to be drunk 2 times a day for 1 cup (you can add honey to the drink). Contraindications for treatment: pregnancy, cancer tumors And allergies on the grass.
If you want to get rid of chronic endometritis by folk remedies, pay attention to the following fee:

Cruise cortex - 10 g;
Mint leaves - 10 g;
Valerian root - 15 g;
The grass of the goose lapping - 15

Getting and use. 4 tablespoons of herbal collection to pour a liter of boiling water, cook on a small fire for 5 minutes, then let it brew for 30 minutes. Straighten the medicine and drink 4 cups per day during menstruation. Repeat such treatment each menstrual cycle. During periods between menstruals, other folk remedies can be used.
Treat chronic endometriosis will help you:

AIRA ROVERVEY - 20 g;
Licorice root - 20 g;
Pirish grass - 10 g;
Grass Ruta - 10 g

Use: 1 tablespoon of grass Fill 1 cup boiling water, let the drug stand under the lid for 10 minutes, then strain. Drink 1 cup drink 3 times a day until the disease stops you disturbing you. Contraindications: Pregnancy, recently transferred miscarriage.

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The mucous layer of the endometrium uterus remains unchanged about a month, then it is separated and replaced by a new layer. Such a state is ideal and remains so in healthy uterus. What is endometritis? If microbes fall into the uterus, sterility is broken, its protective layers are inflated, including endometrium. Endometrite disease occurs, the symptoms and treatment of which will consider below.

Bacteria can hit the mucous quickly, begin to occur sharp painful symptoms Endometritis in women. The disease will acquire acute character. If the treatment of such a form was carried out, but it turned out to be ineffective, and the disease did not leave, but only hid, it acquires a chronic form.

The signs of the chronic endometritis are not so pronounced and at first glance are not even noticeable. You can only determine the disease by making the necessary examination.

The acute endometrite of the uterus is more often caused by mechanical damage, and sex tract diseases lead to chronic inflammation.

Endometritis is quite frequent phenomenon, especially after childbirth. Endometrite after abortion is also not uncommon, as after various operations on the genitals. Fortunately, it is well treated.

Views

There may be a disease in several forms: acute, subacute and chronic. Depending on the causative agent of infection, there may be specific (endometrite on the background of trichomonas, tuberculosis bacteria and other bacteria) and non-specific endometritis (due to conditionally pathogenic microbes). Other types are allocated:

Focal - chronic endometrite, affecting the mucous membrane partially, foci;
Purulent is one of the most dangerous forms. Arises due to the accumulation of pus due to infectious disease. In the conquered bacteria, the uterus of blood clots and the remnants of the placenta are blocked by the cervix, the outflow of the content is difficult;
An autoimmune endometrite is a form of the disease in which antibodies to their own cells of the endometrium are formed in the uterus. Chronic autoimmune endometrite becomes possible in violating local immunity;
Endometrial hyperplastic process refer to benign oncological diseases. Pathology can be detected in women and girls at any age, but the greatest number cases noted for the period of menopause;
The postpartum purulent-catarrhal endometrite is acute inflammation in which the contractile function of the uterus is disturbed, pus is formed. However, such a classification is more used in the treatment of animals, not people;
After the charge endometrite - arises due to infection in case of traumatic intervention in the interruption of pregnancy. The consequence of such a disease can be focal endometritis;
Postpartum gangrenoz - occurs after deep injuries in childbirth with damage to anaerobic bacteria. Notes heat, complete absence of appetite, rapid pulse, selection with a grind smell.

It may also be endometritis after hysteroscopy, after a vacuum of aspiration, since it's all - interference in the internal environment of a critical organ.

The reasons

Endometritis of the uterus is inflammatory. Endometrial inflammation occurs due to intestinal sticks, streptococci, chlamydia, staphylococci, trichomonad, viruses.

All these microorganisms fall into female Organ Several ways:

From the cervix or vagina;
With lymph;

Most frequent reasons Endometritis is insufficient compliance with the rules of hygiene, after childbirth and abortion (due to poor-quality scraping of decidual tissue). If the myometrium (muscle tissue) is also infected after the endometrium, the disease turns into a metroendometritis.

Endometritis, what is it? Consider more.

Two layers work in a healthy uterus: basal and fuctal. The latter rejects once a month by the body and is displayed along with the monthly. The basal layer at the same time works to create a new functional layer.

The structure of the functional layer is very fragile: glandular cells are located between cylindrical cells, and the spiral arteries fill the remaining space. Such a structure is broken immediately after entering this environment of viruses or microbes.

What can cause a violation of the structure of the endometrial of the uterus? The causes of the occurrence of endometritis are:

Hysteroscopy;
Non-acceptance douching;
Protecting the uterus.

Endometrite after the scraping of the uterus is also a common occurrence. Up to 60% of diseases fall on the period after delivery (20% - after natural and 40% - after cesarean section). This is due to the hormonal and immune restructuring of the body, the residues of decidual tissue, as well as the general weakening of the body.

Diagnostics

When visiting the doctor, he first hears all the complaints of the patient. Then he will hold a gynecological examination at which it will estimate the selection on the amount, color and smell, and also takes the smear to further analysis. This will help identify infection pathogens.

If necessary, an additional diagnosis of endometritis is appointed by a gynecologist, namely: blood delivery for analysis, ultrasound. The disease can lead to the seal of the uterus, the damage to the fallopian tubes and the ovaries. Ultrasound will help to see and evaluate the degree of coverage of infection. Echography will help determine the shape and magnitude of the sealing on the mucous membrane, the uterus pain, and whether the endometrium is necrotized or not. You can also see areas of fibrous and sclerosis formations. To identify endometrite diagnostics may be required and more extensive.

Symptoms

Already a few days after manipulations in the region of the uterus, some unpleasant sensations may arise. How to identify endometritis? This can be done by the following features:

The body temperature ceases to be normal and rises to 39 degrees;
Headaches may occur, loss of appetite;
The bottom of the belly moans from pain, both strong and weak, in the lower back;
Endometritis selection unpleasant odormay be with bloody clots;
Painful urination, pain during defecation. The reason for this is inflamed and growing in the volume of the uterus;
In rare cases - uterine bleeding. It occurs more often in women who use intrauterine spirals. In such patients, endometrite disease proceeds with special severity. Bleeding may occur in the middle of the monthly cycle. The source of bleeding is most often a portion of the endometrium, where the pronounced cells of cells.

Such manifestations of the disease can feel 7-12 days. If they are pulled out or engaged in self-medication without choosing proper option, bright symptoms may disappear. They will change their other signs of endometritis, characterizing the sluggish endometritis.

How does chronic form manifest? Her symptoms are not so pronounced as in acute form. They are for a long time There may be masked and be insignificant, so the patient may not pay attention to them. Nevertheless, you need to listen to your body and with the following signs to consult a doctor:

Painfulness in the abdomen of non-messengers or nunning;
A small temperature in the range of 37 - 37.5 degrees;
Brown discharge from the vagina with the pus. They correspond to the disease that are caused by: gonorads, trichomoniasis and other diseases. It occurs purulent endometritis;
Menstruation becomes longer and sometimes continue more than 7 days.

The endometritis manifests in chronic form leads to structural changes in the mucous membranes, which are associated with the formation of a cyst and a tissue disorder. It is for these reasons that patients develop infertility and the inability to endure the child, because the fertilized egg does not have the ability to attach to the walls of the uterus.

Symptoms of the disease may vary depending on some factors. These include: the state of immunity of a woman, the age of the patient, the area of \u200b\u200bdamage to bacteria, the presence of predisposing conditions (especially seriously illness passes on the background of the Navy, childbirth and miscarriage).

Treatment

Having reveaing the sick endometrial symptoms, and the treatment is appointed appropriate. The sharp form is almost always treated in the hospital with a careful observation of the doctor.

On time, the initiated treatment of chronic form will lead to the fact that endometrite in women will quickly pass, without leaving the serious consequences (including infertility). How to treat? Acute inflammation of the uterus is treated in several stages:

Apply antibiotics intravenously. It is more often a metragil with cephalosporins, gentamicin intramuscularly introduced. Such a combination of drugs helps to achieve large results, if several types of microorganisms are to blame;
Antimicrobial phasinity preparations, tinidazole are prescribed if the inflammation of the uterine mucosa is caused by protics, trichomonas, anaerobic bacteria;
In the presence of fetal residues or remnants of the placenta, scattering of the uterine cavity is carried out;
Immunity is raised by cycloferon, T-activin, visiferon, bass. In addition, the tincture of Eleutherococcus, ginseng, is required to receive vitamins;
Pain can be removed by diclofenacor, indomethacin, but shpay;
Finishes physiotherapy treatment.

Often they are resorted to physical forms of treatment - the cold is applied on the supel part. Acting for skin receptors, the cold has an painful and anti-inflammatory effect. This method is carried out with interruptions in half an hour every two hours.

If the diagnosis of inflammation of the mucous membrane is chronic, treatment is somewhat different, as it should be directed to the destruction of a particular causative agent of infection. For this purpose, a certain course of antibiotics or antiviral drugs is appointed for the analysis of smears on sowing.

In addition, assigned:

Resinking drugs such as lidase or scarlet in ampoules;
Hormonal contraceptives are regular, Yarina. They can be replaced by drugs that are artificial progesterone Duphaston, uremines. They have antioxidant actions and help to normalize the monthly cycle;
Preparations responsible for stimulating immune system Riboxin, Wobenzim, Actovegin;
Y-aminocaproic acid solution. With it, you can stop bleeding. It is introduced into the uterine cavity of 3-5 ml of 5-7 days in a row;
Therapeutic dirt, UHF, magnetotherapy, electrophoresis with iodine, zinc. Procedures are carried out in order to activate blood circulation in patients, stimulating their function;
The inflammation of the inner shell is treated with the use of microwaves of the centimeter range or the magnetic field of UHF. On the third year of the disease, ultrasound or iodine electrophoresis are carried out.

The most effective is the input medical preparations Directly into the uterus, thereby achieved the greatest concentration of such drugs in the lesion focus.

Simultaneously with the treatment of a woman, its sexual partner is also treated.

It is believed that treatment has passed successfully, and the danger passed, if the signs of the endometritis completely destroyed: the infection is eliminated, the monthly cycle has normalized, the painful syndrome has been eliminated, restored reproductive function, Endometrial structure is restored.

Complications

Professional treatment, specially selected for each particular person, communicated to complete recovery, will help avoid patient problems in the future. What is dangerous endometrite? The consequences can be caused by both forms of the disease. They can appear as follows:

Spikes are formed in the field of the female organ;
Endometriosis development;
There are problems with pregnancy and childbirth. There may be pregnancy outside the uterus, stillbirth, not to wear, baby infection;
Placental insufficiency arises;
May be bleeding;
There is a risk of polyps;
The inflammatory process can turn into the fallopian tubes and ovaries;
The appearance of pain can be chronic, endometrial fabrics begin to overtakely die.

In order to prevent all these troubles, the woman should take care of his health in advance.

Prevention

In order to avoid the disease in the form of consequences after cesarean sections, abortions and other interventions in the uterus, doctors prescribe antibacterial drugs.

Compliance with one hundred percent sterility during all medical manipulations should be a law for all acting persons. Endometritis prevention includes observance of sexual hygiene.

Timely treatment of all infectious diseases is also a means of prophylaxis from the disease of the endometrium of the uterus.

In addition, all women need to learn to follow their health and take it. A visit to the gynecologist twice a year is a guarantee of timely identification of infections and treatment without complications.

The site provides reference information. Adequate diagnosis And the treatment of the disease is possible under the supervision of a conscientious doctor.

PCR diagnostics. The study is used to identify various specific infections. It is carried out for the diagnosis of venereal diseases.

Linked immunosorbent assay. This study of blood also helps in identifying venereal diseases.

Treatment of acute endometritis

The treatment of endometritis must be comprehensive, timely and adequate. Endometrite cause various infections, because the use of antibiotics is the basis of treatment. Before appointing antibiotics from the uterine or vagina, a smear is taken for bacteriological research and determining sensitivity to infection to different types Antibiotics. It would be logical to prescribe those antibiotics to which sensitive infection. But, unfortunately, the results of bacteriological research will not be earlier than 7 days after taking a smear. It is impossible to postpone the treatment of endometritis for this period, because, in parallel with bacteriological researches, antibiotics of a wide range of action is treated.
What combinations of antibiotics are used?

Combination of penetallines and beta-lactam antibiotics:
Augmentation 1.2 g. (intravenous) 4 times a day + Unazin 1.5 g. (intramuscularly) 4 times a day.

Combination of second-generation cephalosporins with nitroimidazoles and aminoglycosides
Cefasoline 1 gr. (intramuscularly) 3 times a day + Half 0.5 g. 3 times a day (intravenous) + gentleomycin 0.08 g. (intramuscularly) 3 times a day.

The optimal dosage, treatment diagram and the duration of antibacterial therapy, is determined by the attending physician of the gynecologist individually. The optimal choice is determined by the following factors: the state of immunity of a woman, the type of infection, the stage of the disease, the dynamics of the process.

In some cases, it is required to wash the uterine cavity with solutions of antiseptics. This is necessary to remove the purulent contents of the uterus, washing the toxins and a decrease in the activity of the infectious process. The ability and necessity of this procedure is determined by a gynecologist individually.

Fighting intoxication
In case of endometritis, the volume of the affected tissues is large, because the number of toxins allocated to the bacteria is large. Finding into the bloodstream, toxins have damaging toxic effect on all body structures. Therefore, it is necessary to take all measures for the speedy removal of blood circulating toxins. For this purpose, various solutions used in the form of droppers (salvory, reopolyglyukin, reform, albumin) are used. Together with droppers, it is possible to use antioxidant preparations (vitamin C).

Immunostimulation
Conducted antibacterial and detoxification therapy can only help the body cope with the disease. Only, the immune system is able to deal with infection. Therefore, it is necessary to create favorable conditions for this struggle. For this, treatment is necessary in a hospital, where conditions for beddown and rational nutrition have been created.

Also in order to increase the protective properties of the body, vitamin preparations are used (vitamin C and vitamins of group B), as well as drugs that stimulate non-specific immunity:

timalin or T activin 10 μg daily, the course of treatment is 10 days
viferon in the form of rectal candles from 500 thousand units, 2 times a day, the course of treatment is 5 days.

Chronic endometritis, causes, symptoms, diagnosis and treatment

As a rule, this disease is found as a result of unambiguous acute endometritis. It is more often observed with prolonged sexual pathiosis, with chronic forms of venereal diseases. However, in some cases, it may also be as a result of complications after cesarean section (it can cause a suture material remaining for a long time in the mucous membrane), with poorly produced abortion (due to the remains of the fetus tissues in the uterine cavity).

How does chronic endometrite develop?

More often in chronic endometritis, its sharp forms are moving. At the same time, on the background of the treatment carried out, the main symptoms subsided. However, moderate soreness, impaired menstrual cycle, moderate allocations from the vagina remain on for a long time.

Symptoms of chronic endometritis

Irregular menstrual cycle
Abundant bleeding during menstruation
The appearance of bleeding in the intermenstrument period
Surability at the bottom of the abdomen is not associated with the phase of the menstrual cycle
Can observe spontaneous abortions (miscarriages) on early timing

Diagnosis of chronic endometritis

A visit to the gynecologist - a physician of the gynecologist will be interested, whether you have acute endometritis, operations on the organs of small pelvis, abortion, scraping or endoscopic operations.
Gynecological research can reveal a moderate increase in the sizes of the uterus, scanty separation from the uterine cavity (the outer zev of the cervical channel). When feeling a patient may make complaints on the strengthening of pain at the bottom of the abdomen.
Ultrasound of small pelvis organs. This study will identify the violation of the endometrium structure, an increase in the sizes of the uterus.
Diagnostic scraping - makes it possible to learn to study endometrials of the uterus. In the future, this will allow to study the structure of the endometrium, to highlight the infectious agent and determine its sensitivity to antibacterial drugs.
PCR Blood will help identify venereal diseases that may cause chronic mucosa inflammation

Treatment of chronic endometritis

Treatment of this unpleasant disease Perhaps only after the causal factor was determined. In the event that this is an infection, the basis of treatment will be the use of antibacterial drugs to which this microbe is sensitive. An antibioticogram is performed before appointing antibacterial therapy and the sensitivity of infection to different antibiotics is determined.

In the event that the reason for the presence of suture material in the uterine cavity, it is necessary to consider together with your doctor a gynecologist with the possibility of removing it.

In the event that the cause was a chronic vaginosis, it is necessary to restore the normal microflora of the vagina with the help of living cultures of useful bacteria (Hilak Forte, Lines, acilakt) and the normalization of immunity.
With all types of chronic endometritis, preparations are prescribed from a group of immunomodulators, vitamin preparations and medicines that stimulate rehabilitation processes in damaged tissues (Actovegin).

Why is the postpartum endometrite develop?

The postpartum endometrite develops as a result of the penetration of pathogenic microorganisms into the uterine cavity through the extended cervical channel. This can be facilitated as features of the flow of labor and postpartum periodand various medical manipulations.

The development of postpartum endometritis contributes:

violation of the integrity of the cervical barrier;
endometrial integrity disorders;
protractable delivery;
manual examination of the uterine cavity;
mother injuries during childbirth;
reduced immunity mothers.

Cell barrier integrity
Under normal conditions, the entrance to the uterine cavity is protected by a narrow lumen of the cervical channel. In addition, the gland of the mucous membrane of this department secrete a special mucus, which overlaps the lumen of the cervical channel, also preventing the infection penetration. Most microorganisms cannot penetrate this barrier ( with the exception of particularly dangerous, such as gonococci).

During childbirth, the clearance of the cervical channel increases several times, and the relative concentration of mucus in it decreases, which significantly weakens the protective properties of the cervical barrier and contributes to the penetration of the bacterial flora from ambient in the uterus.

Endometry integrity violation
Under normal conditions, the endometrium is a good bloodwave mucous membrane, which also contains the cells of the immune system - macrophages ( absorbing and destroying alien microorganisms), lymphocytes, histiocytes and others. This to a certain extent prevents the attachment and development of pathological bacteria in the cavity of the organ. After delivery, the portion of the inner surface of the uterus, to which the placenta was attached is a wound surface of a large diameter, in the region of which protective properties are practically absent. As a result, the bacteria can propagate fluently, leading to the development of endometritis.

The final restoration of the endometrium occurs within 4 - 6 weeks after childbirth. Whole this period is potentially dangerous in terms of the development of infectious complications.

Protractable delivery
Delivens are considered to be childbirth, which lasts more than 18 hours at primordin and more than 13 hours in repeated women. In addition to the immediate danger to the fetus this situation represents the danger and for the mother, as long anhydrous period (after death amniotic fluidbut before the birth of a child) I. outdoor canal The cervicals contribute to the penetration and development of infection in the uterine cavity.

Manual uterus examination
Within 15 - 20 minutes after the birth of the child, the uterus is re-reduced and the birth of the last ( that is, the selection of placenta and the fetal shells from the uterine cavity). If this period is delayed or proceeds with any violations ( for example, the doctor discovered the gaps or deformation of the placenta, indicating that part of it could stay in the uterus), the doctor performs a manual examination of the uterine cavity in order to remove rest residues. Although this manipulation is made in sterile gloves and in compliance with all the rules of aseptic, the risk of enhancing infection and the development of endometritis increases several times.

It is worth noting that if the fragments of the lapse remain in the uterus, it will also lead to the development of endometritis in the postpartum period.

Mother injuries during childbirth
During childbirth, various damage to the internal organs of a woman may arise ( tarve the cervix, uterus break), which lead to a violation of the barrier function of the organ, and also require additional surgical interventions ( enchanting wounds), contributing to the development of endometritis.

Reducing the immunity of the mother
Immunity suppression ( protective properties of the organism) Mothers during pregnancy is a natural process that prevents the development of immune reactions against the fetus. The negative side of this process is to reduce the organism resistance to pathogenic microorganisms, which contributes to the development of various infectious processes, including endometritis.

Can Endometrite develop after cesarean section?

The development of endometritis after cesarean section is observed less often than after natural labor, but also represents a serious danger to the health and life of a woman.

The cesarean section operation usually lasts no more than 30 - 40 minutes and is an artificial delivery in which the fruit is extracted through a cut in the front wall of the uterus. Although the operation is performed under conditions of sterile operating system in compliance with all Asepta rules ( prevent microorganisms from entering an operating wound), certain bacteria can still penetrate the uterus ( for example, out respiratory tract girlfriend or medical personnel, with skin Pokrov Hoeers with poor processing and so on), which can lead to the development of endometritis.

Caesarean section can be performed in a planned manner either by emergency testimony, and the operation of the operation and the risk of early postoperative endometritis in both cases is different.

Differences between the planned and emergency cesarean cross section

Criterion	Planned operation	Emergency operation
*Indications*	unwanted women to give birth; large fruit; narrow pelvis; multiple pregnancy; placenta Prelations ( when it overlaps the outlet of the uterus, preventing the birth of a child) And other anomalies that can create difficulties during childbirth.	Pulling the placenta, the threat of a break of the uterus during battles and other pathology of the generic activity, which are dangerous to life a woman or child.
*Term of the operation*	Before the start of labor.	Usually after the start of the generic activity.
*Technique operation*	The incision in the uterus is produced in a horizontal direction, along the muscular fiber body, which contributes to the early healing of the wound. The cut length usually does not exceed 12 cm.	The incision is more often produced in the longitudinal direction to prevent injury to the fetus when it is removed. The cut length can exceed 12 cm.
*Risk of postoperative endometritis*	No more than 5%.	From 25 to 85%.

It is worth noting that the antibioticoprophylaxis in the preoperative period ( that is, the introduction of antibiotics a few days before the operation) It is impossible, since most antibiotics penetrate the placental barrier and can have a damaging effect on the fruit. At the same time, the use of a wide range of action of at least 7 of it after the operation significantly reduces the risk of endometritis in both the planned and an emergency cesarean section.

Is it possible to get pregnant during endometritis?

It is impossible to get pregnant, to endure and give birth to an endometritis. Moreover, if this disease does not heal in time, the developing complications may cause infertility for the rest of their lives.

At the beginning of pregnancy, a number of key processes occur, the normal course of which is important for the further development of the fetus. During the conception of men's sex cells ( spermatozoa) penetrate the uterine cavity, and then in the fallopian tubes, where the merger of one of them with a female genital cell ( egg cell). The resulting cell ( zygote) Begins to share, while gradually moving into the uterine cavity. On March 8 - 9, after conception, the implantation of the future embryo ( blastocysts) to the functional layer of endometrial ( mucous membrane interior surface Matties). On the surface of blastocysts, finger-shaped films are formed, which penetrate the endometrium deep into and perform the fixation and nutritional functions ( endometrium glands produce nutrients). The functional layer of the endometrium is thickened under the influence of the progesterone hormone, until it is completely surrounding the attachment blastocyst.

When developing endometritis, there is a violation of the above processes, as a result of which the development of the fetus becomes impossible. Mechanisms of pregnancy violations vary when different forms Diseases.

From a clinical point of view distinguish:

acute endometrite;
chronic endometritis.

Acute endometrite
It is inflammation of endometrial infectious nature. Infection ( bacterial, viral, fungal or other nature) amazes as a functional layer ( usually separated during menstruation) and the basal layer responsible for regeneration ( restoration) Endometrial.

The development of acute endometritis is accompanied by the edema of the endometrium and the microcirculation violation in it. This is manifested by the expansion of blood vessels and an increase in the permeability of their wall, which leads to the exit of the liquid part of the blood from the vascular bed and the formation of the exudate ( inflammatory liquid rich in squirrels), often purulent. There is a pronounced infiltration of endometrial leukocytes ( neutrophils, lymphocytes) - protective cells of the immune system, which are struggling with alien microorganisms. In these conditions, the process of fertilization is impossible, since the spermatozoa is destroyed in the uterine cavity without reaching the egg. If all the same fertilization happened, the blastocyst will not be able to attach to the wall of the uterus due to development inflammatory process, leukocyte infiltration and constant excretion of exudate.

Chronic endometritis
It is usually the result of a non-coherent acute endometritis and is characterized by a long, sluggish inflammatory process in the mucous membrane of the uterus. Clinical manifestations of chronic endometritis can be very scarce, in view of which a woman can try to get pregnant for a long time ( no result), not even suspecting the presence of this disease.

Chronic endometritis is characterized by:

Fibrosis - Arrangement of the connective rubatova) Fabrics in the mucous membrane of the uterus.
Lymphoid infiltration - Cophes big number lymphocytes in the basal layer of endometrial.
Atrophy of the glands -reducing the number and death of the endometrium gland, which is manifested by its thinning.
Education cyst - The growth of the mucous membrane of the uterus ( which can be observed in chronic endometritis) results in squeezing output output glands, as a result of which cavities filled in the secreter of these glands are formed.
Education of adhesions ( sinekhiy) – Connectant jumpers between the uterus walls and in the fallopian tubes that are formed due to the chronic inflammatory process.
Hormone Sensitivity Disruption - It occurs due to the fact that the concentration of receptors to steroid sex hormones decreases in the uterus mucous membrane including progesterone, "preparing" endometrium to implantation blastocysts).
Frequent bleeding - Develop due to disruption of restoration capacity and weak contractile activity of the uterus.

The changes described make it impossible to conceive the process of attachment, attachment blastocysts to the wall of the uterus and the further development of the fetus.

What is the difference between endometritis and endometriosis?

Endometritis and endometriosis are two separate diseases that differ due to the occurrence of the development mechanism and treatment approaches.

Endometritis is an infectious inflammation of the uterine oral mucosa ( endometrial), which develops as a result of penetration of alien microflora from outside. Despite the possibility of the development of dangerous complications ( such as infertility), acute endometrite quite well treat antibiotics.

In case of endometriosis, the migration and growth of endometrial tissue in various sections of the human body are observed. Under normal conditions, the endometrium is present only in the uterine cavity and is represented by two layers - functional and basal, which vary depending on the phase of the menstrual cycle. Under the influence of hormones ( progesterone and estrogen) Endometrial preparations for the implantation of the embryo ( there is an arrangement of the functional layer, the appearance of a large amount of glands and so on). If pregnancy does not occur, the concentration of estrogen and progesterone in the blood decreases, which leads to the rejection of the functional layer of endometrial, that is, to menstruation, after which its gradual recovery begins ( at the expense of the basal layer).

In endometriosis, endometrial cells can be located almost in any organ ( however, usually the walls of the uterus and the small pelvis organs - bladder, ovaries and others). They are subject to the same cyclic changes as the endometrium in the uterine cavity ( that is, grow under the action of sex hormones), which will determine the clinical picture of the disease.

The main differences between endometritis and endometriosis

Criterion	Endometritis	Endometriosis
*The cause of the occurrence*	Penetration of infection in the uterine cavity. *Development of endometritis can contribute:* infections of the vagina; complicated childbirth; cesarean section; any medical manipulation ( abortion, instrumental research, installation of intrauterine contraceptives etc).	There are several theories of the development of the disease, but the specific reason is unknown. *A possible cause of endometriosis can be:* Disruption of the embryonic tissue laying, as a result of which the endometrium fabric develops in various organs. Menstrual blood casting together with endometrial cells in abdominal cavity (through the royal pipes). Tumor rebirth of cells of various tissues and organs.
*Development mechanism*	The reproduction of the bacterial flora leads to the development of the inflammatory process characterized by damage and disruption of the endometrium function.	Endometrial fabric can germinate in various organs, disturbing their anatomical integrity and functional activity.
*Main clinical manifestations*	soreness at the bottom of the abdomen; purulent / bleeding from the vagina ( outside menstruation); menorragia ( abundant menstrual discharge); general symptoms intoxication ( increase body temperature, headache, pain in muscles and so on).	The clinical picture is determined by the organ in which the endometrium tissue is growing. *Endometriosis can manifest:* Pain -it can be localized in any department of the abdomen, enhanced during intercourse, during menstruation or without a visible cause. Uterine bleeding -up to the development of anemia ( lack of red blood cells and hemoglobin in the blood). Violation of urination -this is usually due to the damage to the bladder. Violation of defecation -with the damage to the wall of the rectum. Heralo -with lung damage. Infertility.
*Principles of treatment*	Adequate and timely antibacterial therapy may result in complete cure.	The main method of treatment is the surgical removal of the resulting endometrial tissue ( if possible). Medicia treatment (hormonal drugs ) It is recommended to apply in the postoperative period in order to prevent complications.

Is it possible to cure endometrite by folk remedies?

Many folk remedies Success is used to treat endometritis. However, it is worth remembering that sometimes this disease can be caused by extremely dangerous microorganisms ( for example, Gonokokki), and in this case without a specialized medical care Healing endometrite will not succeed. That is why before starting self-medication folk methods It is recommended to consult a doctor.

In the treatment of endometritis applies:

Methers-and-stepmother. Tanning substances included in the plant have a pronounced anti-inflammatory and antibacterial effect. For the preparation of infusion 50 grams of crushed grass, colts-stepmother must be pouring 1 liter of boiled water and insist for 4 hours. After that, thoroughly strain and take inside 1 tablespoon 4 - 5 times a day.
Infusion of nettle leaves. Neprug has anti-inflammatory and antimicrobial effect, improves the metabolism in the body and increases the contractile activity of myometrium ( muscular layer of uterus). For the preparation of infusion, 1 tablespoon of crushed nettle leaves pour 1 liter of boiling water and insist for 2 to 3 hours. Strain and take inside 1 tablespoon infusion 4 - 5 times a day half an hour before meals and before bedtime.
Wrestlers from blueberry berries. It has anti-inflammatory, binding, antimicrobial and weak diuretic action. To prepare the brave of 100 grams of dry berries Blueberries, it is necessary to pour 1 liter cold water, Bring to a boil and boil for 10 minutes. Cool down room temperature and take inside at half a glass ( 100 ml) 3 times a day.
Nastya yarrow and a hormour. The yarrow has an anti-inflammatory and wounding effect, while St. John's wort increases the physical endurance of the body. For the preparation of infusion you need to take 1 tablespoon of each ingredient ( in crushed form) and pour 500 ml of boiling water. Insist for 2 hours, after which it is to strain and take 50 ml ( quarter cup) 3 times a day.
Plane of the plantain. Substances included in this plant have anti-inflammatory and antimicrobial effects ( active in relation to staphylococci, streptococci and some other microorganisms). For the preparation of tincture, 2 tablespoons of crushed grass of the plantain are poured 200 ml of vodka and insist in a dark place for 2 weeks. Before use, strain and take 1 tablespoon 3 times a day. The duration of treatment is not more than 1 month.
Drawing a vaginal decoction from oak bark. Oak bark contains tannins with astringent and anti-inflammatory effects. In addition, it includes flavonoids - biologically active substancesWarning tissue damage under various inflammatory processes. To prepare a decoction, 100 grams of crushed oak crust pour 500 milliliters of boiled water and bring to a boil on slow fire. Boil for 20 minutes, and then cool at room temperature, thoroughly strain and add 1 liter of boiled water. The resulting decoction is used in warm form for douching ( washing) Vagina. For this purpose, you can use a conventional medical pear or a special fringe.

Is there a prevention of endometritis?

The prevention of endometritis is aimed at preventing the penetration of pathogenic microorganisms into the uterine cavity, and if it happened, there is a speedy destruction.

Endometritis is an infectious inflammatory disease that affects the uterine mucous membrane ( endometrium). In normal conditions, the bacteria cannot penetrate the uteros, as this prevented the narrow clearance of the cervix and the cervous mucus in it. In addition, the normal microflora of the vagina also prevents the development of alien microorganisms.

The development of endometritis is possible only after a disruption of the integrity of the described barrier, which is observed in various medical manipulations ( abortion, finger study of the vagina, caesarean section), with natural childbirth or during vaginosis ( replacement of normal marginal microflora on pathogenic microbial associations). In this case, alien bacteria fall on the endometrium surface, causing the development of the inflammatory process and clinical manifestations of the disease.

Endometritis prevention implies:

Compliance with personal hygiene. Regular hygiene of external genital organs prevents the development of vaginosis and reduces the risk of penetration of pathogenic microorganisms into the uterine cavity.
Protected sex contacts. Using physical ways protection ( condom) not only prevents unwanted pregnancybut also helps protect against various sexually transmitted diseases ( chlamydia, gonorrhea and other).
Timely treatment of infectious diseases. Adequate treatment of sexually transmitted infections are starting with the use of a wide range of action antibiotics ( for example, ceftriaxone 1 gram 1 time in the knocks intramuscularly). After receiving the results of the antibioticogram ( studies determining the sensitivity of specific bacteria to one or another antibiotic) The most efficient antibacterial drug should be applied to complete recovery, and at least 3 - 5 days after disappearances clinical manifestations Diseases.
Research of the vaginal microflora before medical manipulations. This study must be held in front of hysteroscopy ( research of the uterine uterus using a special apparatus), abortion, natural childbirth and other events in which the risk of infection of the uterine cavity is increased. If the pathogenic microflora is detected, then the study is deposited, and antibacterial drugs are prescribed. Before performing the planned manipulation, a re-study of the microflora of the vagina is shown.
Preventive use of antibiotics. After cesarean section, complicated childbirth, abortion or other medical manipulations associated with an increased risk of infection, it is recommended to take antibiotics of a wide range of action at least within 5 days. This will prevent the development of the pathogenic bacterial flora, which could get into the uterus. In the absence of pregnancy, antibioticophylaxis can be prescribed before the planned manipulation.
Ultrasound procedure (Ultrasound) In the postpartum period.This study is carried out by women who have a childbody proceeded with any complications. Although ultrasound does not allow diagnose endometrite on early stagesWith it, blood clots and the remains of the pillar can be detected ( placents and fetal shells that usually stand out from the uterus after the birth of a child) In the uterus cavity. These complications with a large probability of probability can lead to the development of postpartum endometritis, so when they are detected, adequate treatment is necessary ( from the appointment of drugs that increase the contractile activity of the uterus to the instrumental removal of the rest).
Regular observation at the gynecologist. Women in reproductive age is encouraged to visit the gynecologist with a preventive purpose at least 2 times a year. At the same time, it is necessary to take a general blood test and a general urine analysis, an analysis on the microflora of the vagina, to carry out an ultrasound of the organs of a small pelvis. The complex of these simple studies will allow you to suspect the presence of an infectious disease in time and assign adequate treatment, which can prevent the development of endometritis. It is worth noting that the risk of developing endometritis is highly high during the first month after installing intrauterine contraceptives ( spirals). Such women are encouraged to visit the gynecologist weekly within 1 month after the procedure, and in the future 1 time in 2 - 3 months.
Adequate treatment of acute endometritis. The treatment of acute endometritis should be carried out by antibacterial drugs for at least 10 days ( sometimes more). Adequate, timely and sufficiently long antibiotic therapy makes it possible to prevent the transition of acute endometritis into chronic, which is difficult to treat and is often accompanied by infertility.

What could be the complications and consequences of endometritis?

Most hazardous complication Endometritis is the spread of infection to other organs and throughout the body, which can lead to very serious consequences ( from infertility to the death of a woman).

In case of endometritis, the infection can be distributed by several paths, namely:

Contact path With the direct transition of microorganisms from the mucous membrane of the uterus to neighboring organs.
Lymphogenic path As part of lymph, which flows from the uterus to sacral and lumbar lymph nodes and further ( through breast lymphatic duct) Enters systemic bloodstream.
Hematogenic way In the penetration of infection into the blood through damaged blood vessels.

Endometrite may complicate:

Metroendometritis -the transition of the inflammatory process from the mucous membrane to the muscular layer of the uterus.
Lymphadenitis - inflammation ( and often supplement) Regional lymph nodes in which the infection has come.
Metrotromibophlebitis - Inflammation of the veins of the uterus as a result of the penetration of pathogenic microorganisms into them.
Cervicitis - Inflammation of the cervix.
Vaginitis - Inflammation of the mucous membrane of the vagina.
Salpingitis - Inflammation of uterine pipes.
Ooforitis - Inflammation of the ovaries.
Peritonitis - Inflammation of the peritoneum ( thin serous shell covering internal organs Abdominal cavity).
Sepsis - A generalized infectious process that develops as a result of the penetration of a large number of pathogenic microorganisms and / or their toxins into blood and without urgent medical care leading to human death.
Pyometro - The accumulation of pus in the uterus cavity, which is due to the violation of the cervical cervix.

The consequences of endometritis and its complications can be:

Chronizing the inflammatory process. With a non-acute acute endometritis, it can go to chronic, which is characterized by a less obvious clinical pictureHowever, more serious and dangerous changes in the mucous membrane of the uterus.
Development of the adhesive process.As a result of the progression of the disease in the focus of inflammation, special cells appear - fibroblasts that begin to produce collagen fibers ( main component of scar tissue). From the data of fibers and spikes are formed, which are dense trash, which "glue" the tissues among themselves. Running, they can squeeze and press various organs ( bladder, intestines) either break the passability of uterus and uterine pipes, which will lead to appropriate clinical manifestations ( violation of urination, constipation, infertility).
Infertility. The inability to conceive and endure the child is the most frequent consequences chronic endometritis. With a given disease, changes occurring in the uterus mucous membrane ( inflammation, cell infiltration by leukocytes, microcirculation disruption and so on), make it impossible to attach the embryo to the wall of the uterus and its further development, resulting in any pregnancy ( if she still comes) It will end in miscarriage in the early stages. The development of the adhesive process in the uterus and uterine pipes can also lead to infertility, since men's sexes ( spermatozoa) will not be able to achieve the female sex cell ( egg cell.) And the conception will not happen.
Violation of the menstrual cycle.Inflammatory changes in the mucous membrane of the uterus lead to a violation of the sensitivity of the organ to hormones ( estrogen, progesterone), which normally regulate the menstrual cycle. In this regard, there may be a delay in menstruation, polymenorrhea ( long and abundant blood loss during menstruation), Metrragia ( bleeding from uterus not related to menstrual cycle) etc.

Can I have sex with endometritis?

It is not recommended to have sex during acute or chronic endometritis, as this may not only complicate the course of the disease, but also lead to infection of the sexual partner.

Endometritis is an inflammatory disease that develops as a result of penetration and reproduction of pathogenic microorganisms in the mucous membrane of the uterus ( endometry), and sexual intercourse may be one of the causes of this disease. Under normal conditions, the only entrance to the uterine cavity ( through the cervix) blocked mucosa plug ( the mucus is highlighted by numerous glands of this area.), which prevents infection from entering outdoor genital organs and the environment. During intercourse, the integrity of this barrier is broken. If you do not use mechanical means of protection ( condoms), infection from a patient partner can penetrate the uterus and cause endometritis.

Sexing with endometritis may complicate:

Repeated infection.The treatment of endometritis is to apply antibacterial drugs in order to complete the destruction of pathogenic microflora in the uterine cavity. If at this time you have sex, the likelihood of re-enhancing infection is high. In this case, the treatment will be ineffective, and the acute endometrite can go into a chronic form. In addition, surviving microorganisms will become resistant to the action of antibiotics applied, which will make further further treatment of the disease.
The spread of infection to neighboring organs. During the intercourse, the integrity of the cervical barrier is disturbed, as a result of which the infection can go to the external genital organs, leading to inflammation of the cervix, vagina and other external genital organs. In addition, cutting in the uterus during orgasm can contribute to throwing infection in the fallopian tubes and the abdominal cavity with the subsequent development of Salpingitis ( inflammation of uterine pipes), ooforita ( inflammation of ovarian) and pelvioperitonitis ( inflammation of the peritoneum of a small pelvis).
Infection partner. Since the cause of the endometritis is the pathogenic microflora, during unprotected sexual contact, a partner may be infected with a partner, as a result of which he can also develop a genital infection - Balanit ( inflammation of the head of the penis) will post ( inflammation of the extreme flesh), Balantostitis, Gonorrhea, and so on.
Pain during intercourse. Endometritis is characterized by the endometrium polynock, disruption of microcirculation and its cell infiltration. In addition, the infectious process often proceeds to external genital organs, which is accompanied by high sensitivity ( hyperesthesia). As a result, the slightest touch of the inflamed organ can be felt by a woman as a strong painful irritation.
Bleeding. As already mentioned, the inflamed mucosa membrane of the uterus is characterized by swelling and full-rod. This is due to the fact that in the focus of inflammation there is a large amount of biologically active substances ( histami and others), which cause the expansion of small blood vessels and an increase in the permeability of the vascular wall. The vessels become more brittle, with the result that the slightest injury can lead to massive and long-term bleeding.
Pregnancy. During the endometritis, the development of pregnancy is almost impossible, since the inflammatory changes in the uterine mucosa prevent the conception and development of the fetus. However, if the conception occurs ( what is possible on the background of the treatment), pregnancy can end spontaneous abortion (miscarriage) Since the developing fruit egg will not be able to attach tightly to the inflamed endometry.

It is worth noting that the use of a condom can prevent the development of some complications ( for example, re-infection, partner infection, pregnancy), but does not protect against other consequences, so sex is recommended not earlier than after 1 complete menstrual cycle after the end of the antibacterial treatment and disappearance of clinical manifestations of the disease. During this time, an endometry functional layer will be updated and the risk of traumatization and damage will be minimized.

Does physiotherapy apply during endometritis?

In chronic endometritis, physiotherapy is an important component treatment, so improves the effectiveness of drug therapy and contributes to easily recovery Patients. In acute endometritis, physiotherapy is usually applied at the restorative phase of treatment, after the completion of the course of antibiotics and subsidiaries of systemic inflammatory reactions.

Physiotherapy implies the use of physical energy ( sound, light, heat and other) In order to the therapeutic effects on individual organizes or the body as a whole.

In case of endometritis, physiotherapy contributes:

normalization of microcirculation in endometrial;
reducing the edema of the mucous membrane of the uterus;
activation of the protective properties of the body;
normalization of the menstrual cycle;
elimination owl syndrome;
reducing the risk of developing complications.

When endometritis applies:

interference therapy;
UHF therapy ( ultra-high frequency);
ultrasound therapy ( Uter);
laser therapy;
ultraviolet irradiation ( UFO).

Interference therapy
The essence of this method is to effect on the body of two currents of average frequency, resulting in human body ( at the point of intersection of current data) The so-called interference low-frequency current is formed, which has a positive effect on the fabric. The interference current with a frequency of up to 10 Hertz irritates the receptor nerve endings in the uterus fabric, causing an increase in tone and the contractile activity of myometrium ( muscular layer of uterus), improving blood supply and trophy ( food) All layers of the authority. Also this species Therapies increase the pain threshold, due to which the subjective feeling of pain is eliminated.

One procedure takes about 10 to 20 minutes. The overall treatment rate is not more than 15 days.
Interference current is contraindicated during an acute inflammatory process in endometrial.

Magnetotherapy
TO positive effects Magnetotherapy applies to anti-inflammatory, anti-ethnic and healing effect. When exposed to a permanent magnetic field, microcirculation improves and intensity increases exchange processes In the mucous membrane of the uterus, which contributes to the speedy healing and restoration of damaged tissue. In addition, the activation of local immunity occurs, the activity of lymphocytes and other cells of the immune system is stimulated, as a result of which the nonspecific protective forces of the female organism are increasing.

One procedure lasts 20 - 40 minutes. Course of treatment 15 - 20 days. Treatment with a constant magnetic field is contraindicated in the presence of uterine bleeding (including during menstruation).

UHF therapy
The essence of this method consists in exposure to the tissue of a patient with an electromagnetic field of high frequency. The resulting energy is absorbed by liquid tissues of the body ( blood, lymphoy) and stands out in the form of heat, that is, a certain organ is heating. The impact of the high-frequency electromagnetic field leads to the expansion of blood vessels, contributing to the exit of immune cells into the focus of inflammation. Also, this method contributes to the subsoil of the acute inflammatory process, in connection with which it is used in acute endometritis.

The duration of one procedure is 5 - 15 minutes. It is not recommended to use UHF therapy over 14 days in a row, as it contributes to the formation of adhesions in the focus of inflammation ( under the action of a high-frequency magnetic field, activation of fibroblasts - cells, synthesizing collagen fibers, from which scar clotum is subsequently formed). For the same reason, the use of UHF in chronic endometritis should be avoided.

Electrophoresis
The principle of this method is based on the movement of particles of a certain substance in the electric field. 2 electrodes are superimposed on the patient's body surface - negatively charged ( cathode) and positively charged ( anode). Both are surrounded by special gauze pads, for one of which ( usually from the cathode) Apply drug Treatment. The cathode and anode are installed in the necessary field of the body in such a way that the body to which needs to be impaired is located directly between them. When the electric current is supplied, the drug begins to move from one electrode to another, while penetrating the tissues incurred on its path.

With endometritis, electrophoresis with copper, zinc, iodine, 10% calcium iodide and other drugs are used. For the treatment of pain syndrome, a 2% solution of novocaine can be introduced. The duration of the procedure is 15 - 20 minutes. The course of treatment should not exceed 15 days.

Ultrasound therapy
Under the influence of ultrasound of a certain frequency in the tissues of the body, a number of changes occur. First, in ultrasound causes microcolement of cellular structures, which contributes to the activation of intracellular enzymes and acceleration of metabolism ( the metabolism process). Secondly, under the action of ultrasound there is an increase in the temperature of the fabric ( approximately 1ºС). All this leads to an improvement in the microcirculation and trophic tissues, acceleration of metabolism and breaking the connective tissue ( what prevents the formation of adhesions).

The duration of one procedure of UTU is 8 - 10 minutes. Duration of treatment from 10 to 15 days.

Laser therapy
The principle of therapeutic effect of the laser is based on the radiation of the light of a certain wavelength. The effect of this radiation on the tissue of the uterine mucous membrane improves microcirculation, increases local immunity and contributes to the early healing of damaged tissues. The laser also has a certain bactericidal action, that is, causes the death of pathogenic microorganisms.

The duration of continuous laser exposure during one procedure is 5 - 10 minutes ( depending on the power of radiation). Course of treatment 10 - 15 days.

Ultraviolet irradiation
Ultraviolet irradiation of the mucous membrane of the vagina causes the death of most pathogenic microorganisms. This method Especially effective in the event that the cause of endometritis was Vaginosis ( pathological statecharacterized by replacing normal microflora vagina alien microbial associations).

One UFO procedure usually lasts from 3 to 10 minutes. The course of treatment is 10 - 14 days.

Despite relative harmlessness, physiotherapeutic procedures have a number of contraindications that need to be considered when applied.

Physiotherapy is absolutely contraindicated:

during pregnancy;
in suspected tumor disease in the field of exposure;
with concomitant endometriosis ( endometrium fabric growing outside uterus).

In other cases, the possibility of using physiotherapy is solved by the attending physician and physiotherapist.

What is the classification of endometritis?

In medical practice there are several endometritis classifications. Their use in the formulation of the diagnosis helps the doctor most accurately assess the severity of the disease and assign proper treatment.

Cystitis. Modern diagnosis, effective treatment and prevention of the disease.

Cervical erosion. Symptoms, modern diagnosis and effective treatment of the disease. How to treat the erosion of the cervix? Calculation of erosion with current, laser, cryodestruction.

Endometritis is an inflammatory disease that affects the inner layer of the uterus (endometrium).

Endometritis is widespread gynecological disease And in 90% of cases is diagnosed in women of reproductive age.

With inflammation of the mucous membrane, the infection inevitably spread to the muscular layer, so it is more expedient to talk about endomyometritis.

Views

For the process, acute, subacute and chronic endometritis are isolated.

A separate graph should be made postpartum endometritis. Endometrite after childbirth ranks first among purulent-inflammatory postpartum complications (about 40%).

By severity of the disease, the endometrite may be light, medium and severe.

The reasons

The reason for the occurrence of endometritis are pathogenic microorganisms, not only bacteria, but also viruses, simplest and mushrooms:

streptococci;
staphylococci;
intestinal wand;
proteus;
klebsiella;
chlamydia and mycoplasma;
mycobacterium tuberculosis;
yeast-like mushrooms;
gonococci;
trichomonas and others.

An infection that causes inflammation of the mucous membrane of the uterus falls into it due to mechanical damage Endometrials and reduction of the protective forces of the body. The predisposing factors include:

intrauterine manipulations (testing of the uterus, installation of the Navy, diagnostic scraping, abortions, miscarriages, hysteroscopy, metrosalpingography);
complicated childbirth (weakness of generic activities, weakness of fence, bleeding in the last period, a long anhydrous interval - more than 12 hours, caesarean section);
non-compliance with personal hygiene and sex acts during menstruation;
violation of the scripture procedure;
the remains of the fetal egg after an abortion or the remains of the last after delivery.

Chronic endometrite arises due to an untreated or not adequately treated acute endometritis.

Endometritis symptoms

Acute endometrite

The acute endometrite begins with a sudden increase in temperature to febrile digits (39.0 - 40.0 ° C), the octvinations alternate with heat, sweating increases, signs of general ailment (weakness, lack of appetite, fatigue) appears.

Characterized by sharp pains at the bottom of the abdomen or spasms in the presence of foreign bodies: Navy, the remains of the last / fetal egg.

Pains can give to the lower back and the crushes.

Selecting from sexual tracks in the acute course of the disease is abundant, serous-purulent or bleeding, the colors of "meat amateur" with an unpleasant smell.

In the presence of residues of the fetal egg, pronounced bleeding is possible.

Chronic endometritis

The clinical picture of the chronic process is lubricated.

The patient presents complaints to permanent subfebrile temperature (37, 1 - 37.8 ° C).

For chronic endometritis are characterized by constant many pain At the bottom of the abdomen, irradiating in the seats and lumbar region. It is also observed a violation of the menstrual cycle (pre- and postmenistric bleeding, bleeding in the middle of the cycle), which is related to hormonal disorders, disorders of transformation of defective endometrial, increased permeability of blood vessels and pathology of the contractile function of the uterus.

The chronic process is accompanied by weakness, fast fatigue, violation of psycho-emotional state.

Pains are possible during sexual intercourse (disposage) and defecation. In 50% of patients there are problems with conception and hacking pregnancy.

Postpartum endometritis

Postpartum endometrite develops by 3 - 5 days after childbirth or cesarean section. Symptoms of postpartum endometritis are the same as signs of acute form.

Diagnostics

The differential diagnosis of endometritis is carried out with adnexite (inflammation of appendages), ectopic pregnancy, appendicitis and parametrity (inflammation of the incoming fiber).

Collection of anamnesis and complaints. Recently conducted intrauterine interventions, childbirth and postoperative period (after cesarean section or abortion).
Gynecological examination. When conducting gynecological inspection The uterus and appendages are palpable. In acute endometritis, the softened, enlarged and painful uterus, in the chronic process, the uterus is compacted, slightly more norms are sensitive to palpation and a displacement for the neck. The nature of the selection (color, quantity, odor) is evaluated.
Muses from the vagina on the microflora. The strokes are investigated cervical canal and the vagina to identify pathogenic microorganisms and evaluating the degree of purity. Bacteriological seedings are carried out to nutritional media in order to identify the pathogen. According to the indications are assigned additional analyzes On sexually transmitted infections (chlamydia, mycoplasmosis, cytomegalovirus and other).
Common clinical blood tests and urine. IN general Analysis The blood is detected to increase the ESP, an increase in the number of leukocytes with a leukocytic formula shift to the left. In chronic endometritis, there is a decrease in platelets, which indicates a violation of blood coagulation, it is possible to reduce hemoglobin (anemia).
Ultrasound of small pelvis organs. During the ultrasound, uterus and appendages are estimated. The dimensions of the uterus and its cavity are determined, the presence of blood clots in it, pus, residues of the fetal egg or synechnia (intrauterine sobbing), the thickness of the endometrium (M-ECHO), the correspondence of its phase of the menstrual cycle.
Hysteroscopy. The study of the uterus by a hysteroscope is carried out with suspicion of chronic endometrite, the endometrium (biopsy of the endometrium) is carried out according to the indications for further histological research.

Treatment of endometritis

Treatment of acute form

Treatment of patients with acute endometritis and exacerbation of chronic is carried out in the hospital. Therapy prescribes and controls its effectiveness of a gynecologist.

First of all, antibiotics intramuscularly or intravenously (depending on the severity of the disease) are prescribed. Antibiotic therapy is selected taking into account the existed pathogen of the endometritis. Preference is given to Cephalosporins (Cefzol, Ceftriaxone, Cefotaxim) and Fluoroquinolones (Ciprofloxacin, Clindamycin).

Often, the combined appointment of antibiotics from different groups. In addition, metronidazole is assigned to tablets or intravenously (metrged), which suppresses an anaerobic flora.

Against the background of antibiotics in order to prevent the vaginal candidiasis and intestinal dysbiosis, antifungal drugs are used (pimapucine, clotrimazole, dieflux).

In order to disinfect and reduce the temperature, infusion therapy is prescribed (physical solution, the glucose solution intravenously).

Optionally used non-steroidal anti-inflammatory funds (indomethacin, diclofenac in tablets and candles), which have anti-inflammatory and painkillers. The reception of vitamins and the correction of immunity by immunomodulating drugs (tutivin, thimalin) is shown.

Treatment lasts 7-10 days.

Treatment of chronic form

After relieving acute period and in chronic endometritis outside the exacerbation, physiotherapy is recommended (UHF on the abdomen, electrophoresis with lidase or copper and zinc on the phases of the menstrual cycle, SMT, etc.). Sick chronic endometritis is assigned to the reception of oral hormonal contraceptives (to restore the menstrual cycle) by 3 - 6 months.

Surgical intervention (scraping of the uterus) is carried out in the presence of residual eggs or parts of the placenta, hematometrs (stagnation of blood in the uterus with a "closed" neck). In case of detection of the synech in the uterus, they are separated and excised during hysteroscopy.

Complications and forecast

TO possible complications Endometritis include:

adnexitis (the spread of infection on the appendages of the uterus);
parametritis;
thrombophlebitis veins of a small pelvis and lower extremities;
sepsis;
impairment of the menstrual cycle;
infertility;
habitual unbearable;
syndrome of pelvic pains (permanent pain at the bottom of the abdomen without visible reasons).

Forecast with acute endometritis is favorable. With adequate treatment and passage of preventive courses, pregnancy occurs in 90% of cases of chronic endometritis.