Endometritis - inflammation of the lining of the uterus (the endometrium). Most often occurs after the abortion, childbirth, diagnostic curettage of the uterine cavity. Acute inflammation can be caused by bacterial, viral, fungal, parasitic, mycoplasmal, and protozoal and spirochetal infection. The most common aerobic-anaerobic noted the association of 4-6 micro-organisms. On the etiology of isolated tubercular, gonorrheal, aktinomikotichesky, as well as non-specific endometritis. In severe cases, inflammation may spread to the muscle of the uterus with the development of mioendometrita.
Clinic endometritis develops, usually on a 3 - 4 days after infection. There have common symptoms: malaise, weakness, fever, increased erythrocyte sedimentation rate, blood - neutrophilic leukocytosis with a left shift and the local: pain in lower abdomen, pus-like leucorrhoea liquid (sometimes sukrovichnye), enlarged and painful on palpation the uterus rather compact consistency.
Acute endometritis stage lasts 8-10 days, and with adequate therapy, complete recovery occurs. In case of incorrect or defective treatment of a transition to the chronic form.
Chronic endometritis is accompanied by structural changes of the endometrium - to atrophy, hypertrophy, or the formation of small cysts. The most severe clinical symptom is a disturbance of the menstrual cycle with the development of pre-and postmenstrual bleeding. Conception does not prevent chronic endometritis, but implantation of the ovum in the endometrium is extremely modified for-trudnitelna. Therefore, reproductive disorders in chronic endometritis can range from sterility to the habitual miscarriage. Patients complain of serous-purulent leucorrhoea, aching pain in lower abdomen. In bimanual study noted a slight increase in the seal and the uterus. Diagnosis of chronic endometritis should be based on data from medical history, clinical and histological examination of endometrial scraping (curettage should be performed at 8-10 days of the menstrual cycle).
Treatment of endometritis
In the acute stage requires causal therapy - antibacterials based sensitivity to the pathogen or broad-spectrum drugs (usually fluoroquinolone). Dose and duration of antibiotic therapy are determined by the severity of the patient. To suppress the anaerobic flora commonly used metronidazole (trihopol, flags, Klion). In addition, the infusion is used, desensitizing, and restorative therapy.
In chronic endometritis using a set of measures to increase nonspecific resistance, treatment of concomitant genital and extragenital pathology, indications for use sedatives and desensitization tool. However, the main role belongs to the physical therapy that improves hemodynamics pelvis, enabling a reduced ovarian function and impaired receptor activity of the endometrium. Applied magnetic therapy, ultrasound in a pulsed mode, electrophoresis with iodine and zinc, paraffin and ozokeritnye application on the lower abdomen, balneotherapy.