China
Africa
Explore chapters and articles related to this topic
Postpartum Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Elena R. Magro-Malosso, Sarah K. Dotters-Katz, Daniele Di Mascio
Endometritis is still an important cause of maternal deaths worldwide, although the use of antibiotics has considerably reduced its incidence [114]. Serious complications of postpartum endometritis include peritonitis, pelvic abscess, and septic thrombophlebitis, which can be associated with septic pulmonary emboli.
Endometritis
Published in Carlos Simón, Carmen Rubio, Handbook of Genetic Diagnostic Technologies in Reproductive Medicine, 2022
Ettore Cicinelli, Rossana Cicinelli, Carla Mariaflavia Santarsiero, Amerigo Vitagliano
In the past decade, there has been growing interest toward the evaluation of endometrial “health” in reproductive issues. Receptivity characteristics of the endometrium have been investigated at a molecular level through whole-tissue transcriptomic profiling, with the purpose of identifying the optimal implantation window in frozen-thawed embryo transfer cycles (1). Moreover, recent studies have shed light on the potential relevance of chronic endometritis (CE), a chronic inflammatory condition of the endometrium, as a causative factor of infertility (2–9).
Postpartum infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The diagnosis of endometritis is usually based upon clinical findings. Fever is the most useful sign and should prompt a physical examination even within the first 24 hours post-partum. In the absence of other signs of infection, continued observation may be appropriate, but further evaluation is indicated if fever persists. Endometritis after cesarean section typically presents within 48 hours of surgery. When endometritis follows vaginal delivery, the diagnosis is made within 7 days in 84% and within 14 days in 98% (6).
Retained pregnancy tissue after miscarriage is associated with high rate of chronic endometritis
Published in Journal of Obstetrics and Gynaecology, 2022
Dana B. McQueen, Kruti P. Maniar, Anne Hutchinson, Rafael Confino, Lia Bernardi, Mary Ellen Pavone
Chronic endometritis is an inflammatory condition of the uterus characterised by plasma cell infiltrate and endometrial stromal changes. These stromal changes include spindling of cells, oedema, breakdown, pigment deposition, areas of hypercellularity, and presence of inflammatory cells other than plasma cells (lymphocytes, eosinophils, neutrophils and histiocytes). In a manuscript published by our group in 2021, we established that endometrial stromal cell changes are essential to the diagnosis of chronic endometritis. While healthy controls may have rare plasma cells identified within their endometrium, in our study no controls had both plasma cells and endometrial stromal cell changes. In contrast, women with a history of RPL frequently had both plasma cells and endometrial stromal cell changes on endometrial biopsy. Currently, known risk factors for chronic endometritis include a history of pelvic inflammatory disease, intrauterine polyps and fibroids (Wasserheit et al. 1986; Crum et al. 2011). The aetiology for increased chronic endometritis among women with RPL is unknown; however, we hypothesise that retained pregnancy tissue (RPT) following miscarriage may be a risk factor.
Nrf2/HO-1 pathway is involved the anti-inflammatory action of intrauterine infusion of platelet-rich plasma against lipopolysaccharides in endometritis
Published in Immunopharmacology and Immunotoxicology, 2022
Peng Zhang, Dan Li, Zongzhi Yang, Pingping Xue, Xiaoqiang Liu
The uterus, specifically the endometrium lining of the uterus, plays significant roles in normal reproductive cycles, implantation and placentation, as well as supporting a healthy fetus until parturition [1]. According to statistics, 15% of infertile women who undertook in vitro fertilization cycles suffered from endometritis, and the prevalence of endometritis was as high as 42% in patients with recurrent implantation failure [2]. Accurate diagnosis for endometritis is still a challenging task under a conventional histopathological analysis [3]. Endometritis represents a persistent inflammation of the endometrial mucosa induced by bacterial pathogens, such as Enterobacteriaceae, Enterococcus, Streptococcus, Staphylococcus, Mycoplasma, and Ureaplasma [4]. Lipopolysaccharide (LPS), a main component of the outer membrane of bacteria, is the pathogen-associated molecular pattern to the innate immune system, which can act as a competent stimulator in the immune system [5]. Therefore, LPS was used in this study to establish both cell and animal model with endometritis.
Intrauterine bacterial growth in elective and non-elective caesarean sections
Published in Journal of Obstetrics and Gynaecology, 2021
Ido Solt, Maya Frank Wolf, Rosa Michlin, Yaniv Farajun, Ella Ophir, Jacob Bornstein
Postpartum endometritis is a common cause of postpartum febrile morbidity, defined as an oral temperature of ≥38.0°C on any 2 of the first 10 days postpartum, exclusive of the first 24 h. The infection begins in the decidua, and then may extend into the myometrial and parametrial tissues (Adair 1935; Filker and Monif 1979). Although most infections are mild, extension of infection to the peritoneal cavity can result in peritonitis, intraabdominal abscess or sepsis. Necrotising fasciitis, necrotising myometritis, pelvic thrombophlebitis and toxic shock syndrome are rare complications (Smaill and Gyte 2010). The infection is polymicrobial, usually involving a mixture of two to three aerobes and anaerobes from the lower genital tract (Patai et al. 2005). Caesarean delivery is the most important risk factor for development of postpartum endometritis, especially when performed after the onset of labour (Burrows et al. 2004; Declercq et al. 2007). Among women who receive antibiotic prophylaxis, which has become standard practice, the frequency of postpartum endometritis is 11% for cesareans performed after the onset of labour and 1.7% for those performed electively (Smaill and Gyte 2010). Other risk factors for postpartum endometritis include: chorioamnionitis, prolonged labour, prolonged rupture of membranes, preterm birth and manual removal of the placenta (Faro 2005).