Late postpartum endometritis: regarding a case
Section: Originales
How to quote
Fernández García A, Fernández García E, Lledó Gómez L, Rives Molina M. Entrometritis puerperal tardía: a propósito de un caso. Matronas Hoy 2024; 12(1):25-35.
Authors
1Ana Fernández García, 2Elena Fernández García, 3Leticia Lledó Gómez, 4María Rives Molina
Position
1Médico Especialista en Medicina Familiar y Comunitaria. Centro de Salud de Tordesillas. Valladolid (España)2Enfermera Especialista Obstétrico-Ginecológica (Matrona). C.S Soldevilla. Madrid (España)3Enfermera Especialista Obstétrico-Ginecológica (Matrona). Hospital General Universitario Dr. Balmis. Alicante (España)4Matrona. Hospital Saint Mary´s. Manchester (Reino Unido)
Contact email: elenafdezgarcia@hotmail.es
Abstract
Introduction: postpartum endometritis is the most common cause of infection after delivery, and it occurs when the vaginal organisms invade the endometrial cavity, mostly bacteria moving up from the urogenital or gastrointestinal tracts during the labour process, causing a localized inflammation in the endometrium, the internal lining of the uterus. This is more common after a caesarean section, and requires immediate treatment. Post-partum endometritis can appear early on, within 48 hours after delivery, or late as in the case presented, within six weeks after delivery.
Objective: to update the knowledge regarding the most common signs and symptoms of late postpartum endometritis and its clinical management in daily practice.
Materials and method: study and analysis of a real clinical case of late postpartum endometritis, supported by relevant bibliography.
Discussion and conclusions: postpartum endometritis is the most common postpartum infection, and must be suspected in any postpartum patient presenting unexplained fever, although a differential diagnosis must be established. The incidence of postpartum endometritis is mostly affected by the mode of delivery; one of the risk factors is having an instrumental delivery, as in the case presented. For all types of endometritis, treatment must be initiated with adequate antibiotics and as early as possible, because a delay in action will have impact on the severity of the condition and the potential complications derived, including sepsis.
In the case analysed, there was fast and effective care for suspected endometritis, which was subsequently confirmed.
It is essential to have an epidemiological surveillance system regularly established, and to use standard or transmission-based precautions, in order to prevent nosocomial infections from spreading at hospitals.
Keywords:
endometritis; family doctor; risk factor´s; postpartum fever; bacteria; infection; sepsis; uterine examination by obstetricians; midwives; Klebsiella pneumoniae.
Versión en Español
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