Chronic metroendometritis, what is it? Endometritis in the general sense of the word is an inflammatory lesion of the functional and / or basal layer of the endometrium (the inner lining of the uterus).
What does the particle "metro" mean in the name of the pathological process? It indicates additional involvement in the pathological process of the myometrium, the middle, muscular layer of the uterine structures.
Thus, metroendometritis is a complex lesion of the uterus involving the inner and middle layers of the hollow organ in the disease process. The disease can occur in both acute, subacute, and chronic phases. What you need to know about the disease?
In most cases, the disease is infectious in nature and is provoked by viruses and bacterial flora. However, the uterus of the weaker sex is a perfectly protected system. On its way, the pathogenic microorganism is found not only with general immunity, but also with a whole complex of tissues that have substantial protection:
Endometrial function layer. It is he who is exfoliated every month and is responsible for menstrual bleeding. In its structure has many glandular cells that produce a special secret. On the one hand, it has bactericidal properties, on the other hand, it mechanically removes viruses, bacteria and their metabolic products.
Basal layer of the endometrium. A deeper structure that actively restores the functional layer. It is richly supplied with blood, due to which it has substantial protection from immunity.
Myometrium Myomery is considered the middle, muscular layer of the organ.
Unfortunately, a good blood supply plays a cruel joke with the body of the weaker sex. If the body is weakened, the proximity of all tissues of the uterus leads to almost unobstructed penetration of pathogenic agents deeper and deeper.
In extreme cases, the serous membrane (peritoneum) may also be involved in the pathological process. It is fraught with peritonitis, sepsis and death. Because it is so important to undergo appropriate treatment.
In total, there are three groups of pathological development factors. The first group is the so-called viral causes. They cause the direct penetration of pathogenic microorganisms and viruses into the sex structure.
First you need to figure out what kind of flora can cause such a difficult disease. According to the research data, the following agents are most often referred to:
- Herpes virus. From the first to the sixth types. Especially often the disease is caused by the herpes simplex virus (strain of the first type), genital herpes (virus of the second type), the agent Varcelle-Zoster (the third type), cytomegalovirus, Epstein-Barr virus.
- Human papillomavirus. In total there are more than 500 types of the specified agent. Everyone can cause metroendometrita.
- Staphylococcus. Representatives of pyogenic (pyogenic) flora. Cause complex forms of metroendometrita with exudation, severe intoxication of the body.
- Streptococcus. Streptococci are similar microorganisms.
- Bacteria that are sexually transmitted, as well as living in the patient's body for years. The so-called pathogenic and conditionally pathogenic flora. She can not show any aggression up to a decrease in immunity and coexist with the patient for years. This includes mycoplasmas, various ureaplasmas, chlamydia, and other microorganisms of a similar type.
These agents and viruses are transported in three ways: lymphogenous, hematogenous and mechanical. Mechanical, in turn, can be either ascending (from the environment into the urethra and sexual passages) or descending (from the fallopian tubes to the hollow organ). The first is much more common.
In general, viruses and bacteria are able to fall into the sexual passages in a variety of ways. However, the main sexual way remains. Including through oral-genital and classical sexual contacts. That is why it is so important to comply with barrier contraceptive measures.
Pathology formation is directly related to the decrease in the activity of the patient's body defenses. What are the reasons for reducing local and general immunity:
- Frequent supercooling. Affect the state of health is not the best way, causing vascular stenosis and inhibition of the production of cells of the immune system.
- Regular acute respiratory viral diseases, other infections of a chronic nature.
- Stress, psycho-emotional overload and other similar factors. They provoke the release of a huge number of corticosteroids in the bloodstream. The result is acquired immunodeficiency (in the broad sense of the word, regardless of the virus of the same name).
- Abuse of alcoholic beverages.
- Frequent smoking Smokers with great experience risk to “get” such a complex disease many times more often. In addition, smokers menopause occurs 3-5 years earlier than usual. Another reason to quit smoking.
Trigger factors are the third group of causes. They directly trigger the pathology formation mechanism. As a rule, the main trigger factor is the presence of various types of damage to the endometrial mucosa. Among the reasons for this kind of distinguish:
- Conducting diagnostic curettage on a large area. By and large, after the intervention, the entire uterus from the inside is one large wound surface. This is a direct way to the formation of infection. Only a very enduring body can tolerate such a procedure without consequences. For this reason, women who have undergone traumatic intervention are recommended to take short-term antibacterial drugs.
- Traumatic interventions of diagnostic type, such as hysteroscopy, sensing, taking material for histological examination, etc.
- Conducting any manipulations inside the uterine structures. First of all, the violation of the rules of antiseptic processing of tools and the banal non-compliance with the rules of hygiene by a specialist.
- Violations of the microflora of the sexual passages. Affects the most negative way. First of all, when the amount of pathogenic flora exceeds the amount of useful flora. Such an imbalance provokes the penetration of harmful microorganisms into the uterus. As a result, the likely development of metroendometritis.
- Heavy labor. Reduced immunity of the mother and other factors of this type.
- Injuries to the birth canal. These are ruptures of uterine structures, ruptures of a vagina, partial tears of anatomical structures.
- The accumulation of blood in the uterine structures. Also during the birth process.
These are the reasons for the formation of chronic metroendometritis. Only in the complex do they initiate the pathological process. The chronic form of the disease rarely develops in isolation. As a rule, it is preceded by an acute phase of varying duration.
Symptoms of a chronic disease of the type described develop sluggishly, but as a rule, they are much more numerous and constitute a single clinical picture. The characteristic manifestations of the disease include the following symptoms.
Endometritis is always characterized by painful sensations. When the process affects the mucous membrane of the organ, the pain is relatively quiet and the patient can easily relieve them with simple anti-inflammatory drugs of non-steroidal origin, or analgesics.
However, as soon as the microorganisms reach the muscle layer, the discomfort becomes extremely intense. Only at this stage, patients begin to see a specialist. The intensity of the pain is extremely high. An unpleasant sensation is given to the groin, lower back, legs, abdomen. Over time, discomfort becomes diffuse. It is impossible to establish the exact location of pain.
- Serous, or serous-purulent discharge from sexual passages.
Their nature directly depends on the main causative agent of the disease. So, when gonococcal invasion most often manifest purulent exudate, it irritates the walls of the sexual passages and causes a secondary pathological process (coleitis).
When the fungal invasion of allocation cheesy, white, with a sour odor. If the discharge is clear, with blood impurities and has a sharp unpleasant odor, it makes sense to look for E. coli, Trichomonas, etc. In all cases, it is not a specific symptom of the disease, which may indicate a simple inflammation of the walls of the uterus.
- Intense pain on palpation.
This is a specific sign of metroendometritis. When external physical examination of the uterus tense, painful. This is an alarming sign indicating the involvement of muscle structures in the disease process. In the course of a bimanual study, even more intense pain is possible, which clearly indicates the appropriate diagnosis.
- Disorders of the menstrual cycle.
It is delayed for several days and begins in an unusual way. Usually, an avalanche-like start of menstruation occurs. The process is accompanied by intense bleeding. Perhaps the formation of secondary anemia.
Also observed symptoms such as:
- abdominal pain at the level of epigastria, in the epigastrium,
- feeling of weakness.
All these are symptoms of general intoxication of the body. Chronic metroendometritis may be asymptomatic. This is rare, but still has a place to be. This greatly complicates the diagnosis of the disease.
Metroendometrit quite difficult to diagnose. Even more difficult to verify the diagnosis. Examination of patients with suspicion of the corresponding disease involved gynecologists. May require consultation infectious diseases. It is mandatory to conduct the appropriate research laboratory and instrumental types:
- Study of capillary blood. Complete blood count gives a classic picture of the inflammatory process with high rates of ESR, leukocytes.
- Smear and sexual tract and cervical canal. Shows a high concentration of leukocytes and the presence of pathogenic flora.
- Bacteriological seeding of secretions from the sexual passages on nutrient media. Shows the type of pathogen, as well as the characteristic sensitivity to antibiotics of one type or another. Allows you to develop a clear therapeutic model.
- Ultrasound examination of the abdominal organs, pelvic organs.
These studies give the most accurate results. Metroendometritis is also diagnosed on the basis of the conducted studies of the physical type.
In all cases, inpatient treatment is recommended. Unfortunately, it is possible to effectively cope with metroendometritis only in the early stages of the disease, in the first 7-10 days from the start of the process. Then to solve the delicate problem is much more difficult. For the whole time of treatment, bed rest is prescribed, strict adherence to all recommendations of the specialist.
The complex treatment is carried out with the use of special preparations of several pharmaceutical groups:
- Anti-inflammatory nonsteroidal origin. Ketroprofen, Ketorolac, Nise, Ibuprofen. Stop inflammation.
- Corticosteroids. Prednisolone, Dexamethasone and others. They relieve inflammation, pain, swelling, stop bleeding.
- Antibiotics. Alpha and Omega competent treatment of the described disease. Appointed, based on the results of special tests on the sensitivity of the flora.
- Also used immunomodulators, vitamin-mineral complexes.
- Preparations may be prescribed in the form of suppositories for vaginal administration or tablets for oral administration.
Metroendometritis is a multifaceted, complex pathology. Even in the chronic phase, it requires mandatory competent, comprehensive treatment. Dealing with this form of the disease is much more difficult. But probably. The help of the gynecologist is necessary.
What is metroendometrit
Metroendometritis is an inflammatory process in the muscle and endometrial layer of the uterus. Inflammation occurs when infectious pathogens enter the uterus or after mechanical action. (childbirth, miscarriage, abortion or the installation of contraceptive coils).
Of course, the woman's reproductive organ has its own natural protection against the ingress of various infectious pathogens. The vagina contains special acids, so most of the microorganisms die already there. The next protective level is the cervical secretion, which consists of immunoglobulins that protect the uterus from pathogenic microorganisms. And the third barrier protecting the body is its mucous layer, which also destroys the causative bacteria. Therefore, if the infection still got into the uterus, and metroendometritis began, then the reasons are:
- Immune weakening.
- Mechanical damage to the uterine wall.
- Foreign bodies in the uterus.
An infection may be due to the following factors:
- operations in the pelvis,
- childbirth or cesarean during which fragments of the placenta remain inside the uterus, the fetus remains without water for a long time, bleeding after childbirth),
- artificial termination of pregnancy, mechanical cleaning after miscarriage, remnants of the ovum in the uterus,
- removing the intrauterine device sooner or later
- blood stasis in the pelvic organs,
- too much douching,
- damage to the pelvic area (injury),
- the presence in the body of mycobacterium tuberculosis,
- intestinal or diphtheria bacillus in the blood,
- streptococcal or staphylococcal infection.
All these factors can lead to the development of acute or chronic uterine metroendometritis.
Forms of diseases
Metroendometrit develops in acute and chronic form. Each of them has its own symptoms and treatment. The acute form proceeds with sharp symptoms, but in some cases, it can turn into chronic.
Acute metroendometrit develops dramatically. First, the temperature rises to 39-40 degrees, feeling weak and dizzy. Lack of appetite, pulls into sleep. This means that an intoxication of the body has occurred. Constantly pulls and hurts lower abdomen. There are bloody or purulent discharge from the vagina with a characteristic odor. If the infection began after birth, then postpartum bleeding does not decline, but rather increases. If untreated, the inflammation proceeds to the next layers of the uterine walls, a pyometer (that is, purulent inflammation), peritonitis, obstruction of the veins in the small pelvis, abscesses develops. The stages of exacerbation alternate with the stages of rest, the pathology passes into the subacute metroendometritis. In subacute form, the symptoms become less pronounced. Intensity of discharge decreases, pain decreases. The inflammatory process subsides, turning into a chronic form. Then, an exacerbation of chronic metroendometritis may begin again.
How to diagnose
To determine the metroendometrit and the type of pathogenic pathogen, it is necessary to conduct a diagnosis. Methods for determining metroendometritis:
- Ultrasound. First on the seventh day of the menstrual cycle, then on the twenty-first day. With metroendometritis, the uterus is dilated, the structure of the endometrium is uneven, the walls of the uterus are not symmetrical, gas bubbles appear.
- Hysteroscopy. Held on the tenth day of the cycle. You can see the change in the thickness of the endometrium, polyps appear, the surface has foci of redness, the endometrium is bleeding. However, this is not a very informative method of research; changes in the mucous layer of the uterus are not always visible.
- Histology. One of the most accurate studies in metroendometriosis. It is done in the first half of the menstrual cycle. According to the analysis, plasma cells and lymphocytes, fibrosis, sclerotic changes in the vessels are present.
- Immunohistochemical analysis. Shows the degree of receptor sensitivity to estrogen and progesterone. By this criterion, the doctor determines the course of treatment.
- Blood test. If there is inflammation in the body, then the leukocytes in the blood are elevated.
Metroendometritis goes through three stages:
- Stage one. The infection gets only on the falling away mucous layer and on separate parts of the endometrium. Where the infectious focus of the endometrium is inflamed and reddens. In the uterine muscle layer, infectious pathogens are absent.
- Stage Two. The infection penetrates deeper, affecting the muscle layers of the uterus. Captures myometrium and tissues located close to it.
- Stage third infection is spread to the uterine lining of the muscular layer, as well as in perimetry and parametrium. If the infection enters the serous layer of the uterus, inflammation forms. Perimetritis is complicated by inflammatory processes in the serous layers of the abdominal organs, which are close to the uterus. The course of the disease is complicated by pelvic peritonitis. Sometimes, the infection can go to the area of the circulatory tissue. Then parmerite occurs. Or both complications may develop at the same time. To prevent complications, you need to pay attention to the symptoms of the disease.
Chronic metroendometritis does not develop as clearly as an acute form of the disease. Often asymptomatic or the symptoms are blurred. The main signs of pathology:
- bloody, purulent, mucous with a grayish tint,
- pain in the lower abdomen and the sacrum,
- the reproductive organ increases, pain is felt when pressing with a finger,
- the cycle gets off, it goes irregularly, too heavy bleeding,
- Difficulties with conception, early termination of pregnancy.
On the background of infection, cystic formations, adhesions, inflammation in the ovaries and fallopian tubes, chronic pelvic pain develop.
Treatment of metroendometritis is prescribed after diagnosis, determination of the pathogen. Treatment of chronic metroendometritis:
It is necessary to treat metroendometritis in a complex way, using both physiotherapy and antimicrobial agents. This gives a faster effect.
- Drug prescribed antibiotics antispasmodics desensitizers immunomodulators and vitamins. Antimicrobial agents are injected into the endometrial layer of the uterus by douching with antiseptics and antibiotics. To reduce the load on the liver, vaginal suppositories with antimicrobial and anti-inflammatory effects are used.
- Physiotherapeutic. Appointed course UHF, electrophoresis and therapeutic baths.
- Surgical If parts of the ovum or stitches are left in the uterus, they are scraped to stop further inflammation.
After the full course of treatment, prophylactic measures should be observed to prevent a new infection.
Metroendometritis during pregnancy and after childbirth
You can get pregnant with metroendometritom, but the development of pregnancy stops. The fruit fades. But it happens that the disease develops already after the onset of pregnancy. Pregnancy complicated by metroendometritis does not proceed very well. Pathology provokes:
- Premature birth.
- Placental dysfunction.
- Oxygen starvation and delayed fetal development.
A woman can give birth both independently and through cesarean section. During childbirth, there may be hypotonic bleeding and other complications, so if a pregnant woman is sick with this disease, it should be especially observed by a doctor. The development of postpartum metroendometritis begins on the fifth or eighth day after birth. With emergency caesarean section, the risk of infection increases several times. A woman feels soreness on palpation of the uterus, the uterus increases, the temperature rises, heartbeat quickens, there is bloody discharge with smell, insomnia.
To prevent infection, you should regularly undergo examinations by a gynecologist and an ultrasound scan. Important timely treatment of inflammatory diseases, protection from unwanted pregnancy. When installing spirals or other intrauterine intervention, it is important to fully observe sterility so that the infection does not get into the cavity of the genital organ.
If you do not treat chronic metroendometritis, then infertility develops, miscarriages or ectopic pregnancy occur. Labor activity is complicated, uterine bleeding may begin after birth. With timely treatment, the reproductive function is fully restored, and within a year a woman can become pregnant and give birth to a healthy child.
Causes of metroendometritis
Taking into account cause-significant factors, two etiological forms of metroendometritis are distinguished - infectious and aseptic. Most cases of the disease are caused by conditionally pathogenic flora or aerobic-anaerobic complexes, which often act synergistically. According to microbiological studies, the most relevant pathogens are staphylococcus, streptococcus, Proteus, intestinal and Pseudomonas aeruginosa, anaerobic bacteria (bacteroids, peptostreptokokki, peptokokkki). Polymicrobial associations are sown in many patients with metroendometritis: Staphylococcus aureus in complex with hemolytic streptococcus, Escherichia coli or enterobacteria. Along with non-specific microflora, gonococci, mycoplasmas, Koch bacillus, and diphtheria bacillus can be found in crops.
Infection in most cases is realized in an ascending way: from the vagina and the cervical canal into the uterine cavity. This is facilitated by various gynecological manipulations - expansion of the cervical canal, abortion, childbirth, installation of the Navy, hysteroscopy, hysterosalpingography, RFE. The source of the downward spread of infection can be fallopian tubes, contact - inflammatory-modified appendix, hematogenous drift of pathogens - distant purulent foci in the ENT organs.
The development of metroendometritis of infectious etiology is favored by conditions that facilitate the penetration of pathogens into the uterus: menstruation, uterine bleeding, venous congestion in the pelvic cavity, nonspecific and specific colpitis and endocervicitis. Post-abortion metroendometrit, as a rule, occurs against the background of incomplete removal of the ovum. Risk factors for puerperal (postpartum) metroendometritis are weakness of labor activity, a long anhydrous period, delayed residues of placental tissue in the uterus, postpartum hemorrhage. The origin of the aseptic metroendometritis is closely related to injuries and bruises of the uterus, exposure to physical and chemical factors (cryotherapy, endometrial ablation, douching). Infectious inflammation in these cases joins for the second time.
The infection process with metroendometritis begins in the basal layer of the endometrium. The lack of a clear anatomical border between it and the myometrium causes the rapid spread of infection to the muscle membrane. The endometrium thickens, loosens, becomes edematous and hyperemic, covered with purulent bloom. Microscopically visualized leukocyte infiltration, degeneration and desquamation of the glandular epithelium. Myometrium is also swollen, infiltrated with lymphocytes and segmented neutrophils. In severe cases, involvement in the inflammatory changes in the serous membrane of the uterus, leading to the development of perimetritis, is noted.
In chronic metroendometrit, edema and hyperemia are less pronounced, lymphocytes and plasma cells predominate in the inflammatory infiltrate. Myometrium is thickened due to the proliferation of connective tissue. Due to the sclerotic processes in the vessels and fibrous transformations of the stroma, the endometrium acquires an uneven thickness, there appear areas of hyperplasia and polypous growths on it. Dystrophic changes of the glands lead to disruption of the secretory transformation of the endometrium and disorders of the menstrual function (anovulation, cycle failure).
Signs of acute inflammation usually appear 3-4 days after the abortion, childbirth, medical and diagnostic manipulations on the uterus. The condition is rapidly deteriorating: the body temperature reaches 38.0–39.0 ° C, chilling appears, marked malaise, tachycardia, intoxication syndrome. There are painful sensations in the lower abdomen and in the sacrum, with palpation, the uterus is enlarged and painful. Abundant dull leucorrhea, serous-purulent, purulent, sometimes with a putrid odor, is characteristic.
The presence of obstacles to the outflow of purulent secretions from the uterus (submucous fibroids, uterine polyps, cicatricial changes of the cervix, etc.) may cause the occurrence of pyometra. In this case, the patient's condition becomes heavier, there are cramping pains in the lower abdomen. With postpartum metroendometritis, lochia is delayed due to poor uterine contraction, bending, or blockage of the cervical canal with blood clots, the development of a lohiometer is possible.
Acute metroendometritis on average lasts from 5-7 to 8-10 days. Blurred forms (for example, against the background of antibiotic therapy) occur with subfebrile temperature. In aggravated cases, the inflammatory process with metroendometritis can spread to the pelvic peritoneum or serous cover of the abdominal cavity (pelvioperitonitis, peritonitis). Gangrene of the uterus and sepsis are considered the most prognostic adverse events.
Therapy of acute metroendometritis should be started as early as possible and carried out in full. Shown rest, bed rest, putting a hot water bottle with ice on the lower abdomen. In order to influence the widest possible range of microbial pathogens, semi-synthetic penicillins (ampicillin, carbenicillin), cephalosporins in combination with metronidazole are prescribed. After receiving the results of microbiological analysis, the correction of antibiotic therapy is carried out.
In cases of severe intoxication syndrome, infusion of colloidal and crystalloid solutions is prescribed. The complex of general drug therapy includes desensitizing, painkillers, uterotonic agents, antispasmodics, vitamins, immunomodulators. A tangible positive effect in the treatment of acute metroendometritis is observed during intrauterine lavage - drip irrigation of the uterus using antiseptic solutions and antibiotics. When parts of the ovum or placenta remain in the uterine cavity, they are removed by vacuum aspiration or curettage. With the development of septic complications, surgery may be required - supravaginal amputation of the uterus or hysterectomy (removal of the uterus with the cervix).
In chronic metroendometritis, along with intramuscular antimicrobial therapy, targeted administration of antibiotics to the uterine mucosa is practiced. Medical douching, physiotherapy treatment (UHF therapy, laser therapy, intracavitary electrophoresis, paraffin therapy, mud therapy, etc.), therapeutic baths (hydrogen sulfide, radon) are used. Correction of ovarian hypofunction is carried out by prescribing hormonal drugs (COCs). In the case of the formation of intrauterine adhesions, their separation is performed under hysteroscopic control.
Prognosis and prevention of metroendometrita
The course and prognosis of metroendometritis depend on the virulence of the pathogens and the patient's body resistance. The outcome of acute endometritis can be both a cure and a chronic disease. The resulting septic complications threaten not only further reproductive plans, but also life. Consequences of chronic metroendometritis inevitably affect fertility, causing ectopic pregnancy, miscarriages, premature births, abnormal location of the placenta, weakness of labor, postpartum hemorrhage, etc.
The warning system for metroenometritis consists of personal prevention and medical control measures. Prevention and timely treatment of inflammatory diseases of the genitalia, the abandonment of abortion, rational management of labor, sterility when performing intrauterine devices, gynecological examinations and ultrasound monitoring will avoid metroendometritis and related complications.
Forms of the disease
There are three forms of pathology:
- Acute metroendometritis - develops with the occurrence of infection in the endometrium, and endometritis occurs. If you start treatment at the time, as the pathology has affected only the functional layer, then you can be cured without complications, easily, with medication. But most often, through the blood vessels, the infection quickly spreads through the other layers, and the treatment becomes more difficult and longer. Also, in the acute form it is impossible to self-medicate, trying to eliminate the symptoms, - this only leads to complications.
- Subacute metroendometritis - a form in which the symptoms are hidden, difficult to diagnose and is a sign of exacerbation of the chronic form.
- Chronic - while in a latent form, it does not manifest itself. Chronic metroendometritis is a complication of acute pathology.
In any form, the main thing is to detect symptoms in time, consult a gynecologist, undergo examination and treatment.
Each form and stage has its own symptoms. For example, chronic metroendometritis develops with almost no signs.
Pathology has an active and latent phase. Thus, the chronic form may not appear at all, especially if there are no other inflammatory infections of the organ.
In the active phase of exacerbation, the following symptoms appear:
- Severe pain during menstruation.
- Soreness during sexual intercourse.
- Lower abdominal pain.
Also, signs of the disease can be detected during a gynecological examination. Palpation can be found seal and increase the size of the body.
An internal examination shows adhesions and ulcers on the endometrium on the vaginal speculum.
In the latent period, or the period of remission, the chronic form manifests differently. And the girl should notice these manifestations in time and turn to a gynecologist.
Symptoms of the latent period:
- Discharge of blood from the vagina outside of menstruation.
- Failure of the menstrual cycle.
- Monthly very long and with severe pain.
- Discharge of pus may appear.
- Flaccidity, fatigue and weakness.
- A slight increase in temperature.
The peculiarity of the chronic form is that with the right course of treatment, a woman can become pregnant and give birth safely.
In the period of gestation, the need for constant monitoring by the attending physician.
Treatment is made with medicines or folk remedies in order to neutralize the inflammatory process triggered by the infection, and the symptoms of metroendometritis are not pronounced.
The most common symptoms may be as follows:
- Soreness during menstruation.
- Discomfort during an intimate relationship.
- General malaise.
Treat pathology needs a complex and phased:
- An antibiotic course is prescribed to neutralize the sources of infection. To do this, use oral tablets. There are also intrauterine drug infusions. So the effect of the drug comes faster. Immunostimulants are given along with antibiotics so that the body's immune system can resist infection.
- Next, prescribe metabolic drugs for oxygenation of the inner layer of the uterus and increases the body's immune defense. At the same time, physical procedures are prescribed to improve blood circulation and dissolve adhesions. And an effective prophylactic and restorative procedure is rest at a resort or in a sanatorium. At the same time it is necessary to adhere to proper nutrition and a healthy lifestyle.
- Also used synthetic hormonal drugs that help restore the work of the uterus and other genital organs. At the same time improve the emotional background.
Application of folk methods
As with the treatment of other diseases, folk remedies very often produce a positive effect. But before using them, you should consult with your doctor.
When pathology used tinctures and decoctions of herbs for douching - chamomile, silverweed goose, nettle, oak bark, rosemary, sage.
If broths to accept inside, then use:
- Decoction Hypericum.
- Calendula tincture.
But effective treatment can only be combined with drug therapy. It is not recommended to engage in self-treatment without the supervision of a gynecologist.
When self-medication, or if you do not go to a doctor for a long time, complications will not keep you waiting. The infection enters the blood vessels, lymph, thus, the blood is infected - sepsis appears.
If the treatment was, but incorrect or not fully completed, the following consequences occur:
- Failure of the regular menstruation cycle.
- Uterine infertility.
- Severe pain in the pelvic area.
If you do not turn to a gynecologist, the following complications appear:
- Pathology becomes chronic, and symptoms will periodically appear throughout life. And with no treatment, the chance of getting pregnant is very small.
- Accumulation of pus in the body.
- The infection spreads to the adjacent organs - the ovaries, sex glands and fallopian tubes, which also drastically reduces the chance of getting pregnant.
- Pus spreads to the pelvic cavity.
These complications are not the limit. There are a number of other effects that increase the risk of infertility.
With the timely treatment of infection complications almost never appear. If the disease is not completely cured, then it will turn into a chronic form and will periodically manifest.
Thus, the risk of pregnancy and gestation is reduced.
If the disease is not treated at all and does not go to the doctor, then this leads to serious complications, such as sepsis and infertility.
Metroendometrit and pregnancy
A feature of metroendometritis during pregnancy is that it appears both during pregnancy and after childbirth.
In the first case, there is a high risk of miscarriage due to infected internal tissue of the uterus, to which the embryo cannot attach.
In the second case, the infection develops immediately after childbirth, and the manifestation of signs occurs only after a week.
In the chronic form, miscarriages often occur at the stage of attachment to the wall, sometimes the girl does not even have time to learn about pregnancy.
And it reflects that this is only an unsuccessful attempt to have a child. Therefore, in case of failure of pregnancy planning, you should seek help from a doctor.
If you still managed to get pregnant with chronic metroendometritis, you need constant medical supervision and regular examinations. Часто будут класть на сохранения. А рожать нужно будет лишь с помощью кесарева сечения.
Metroendometritis is an infectious inflammation that quickly and acutely develops, and with improper therapy or no treatment at all, a chronic form appears.
Pathology is dangerous for its consequences, including infertility and sepsis. But with timely and proper treatment, it is possible to get rid of it without complications.
Signs of the disease are not always pronounced, so you need to regularly visit a gynecologist.
Meet the concept of metroendometrita
This disease is characteristic only for the fair sex. The whole problem is that in some cases, as a result of the influence of many factors, an inflammatory process develops inside the uterus. At the same time, not only the epithelial layer is captured, but also the muscular one.
The reasons for the occurrence of the disease mass. The most important thing is to recognize it in time and begin an effective treatment. Only in this case, you can be sure that the chronic metroendometritis will not lead to complications.
The disease is quite serious for women who are just about to become mothers. The inflammatory process in the uterus leads to adhesions, which are a serious obstacle to the attachment of the fetus.
Causes of disease
The female body is designed in such a way that every month, under the influence of sex hormones, suitable conditions are created for fertilization and gestation of the future baby. The fetus develops in the uterus, it is simply the perfect place with the best conditions.
Implantation of the fetus occurs in the inner lining of the uterus. In a healthy body, it is absolutely sterile, has a supply of nutrients and is able to create all the conditions for the development of the fetus.
But, unfortunately, not always everything is so perfect. In the modern world, women often suffer from inflammatory diseases of the genital organs, which means there is a high risk of infection getting inside the uterus. If a woman has lowered immunity or the treatment of inflammatory processes has not been carried out or has not been completed, then the infection easily settles on the inner mucous membrane of the uterus and feels fine there.
Many factors can provoke an inflammatory process, among them are:
- Surgical intervention.
- Complicated postpartum period.
- Difficult childbirth.
- Frequent douching.
- Examination of the uterus or fallopian tubes.
- Curettage of the uterus in cancer.
- Surgical procedures for diseases of the uterus.
Various infectious diseases can provoke chronic metroendometrit, primarily those that are sexually transmitted, for example:
- Intestinal or diphtheria bacillus.
- Mycobacterium tuberculosis.
All these reasons can not only give impetus to the onset of the development of an inflammatory disease, but also rather quickly contribute to the spread of infection in the uterine cavity.
It is worth noting: if metroendometritis, which first appeared about itself, is not effectively treated, then, most likely, it will turn into a chronic form and will periodically remind of itself.
Risk factors for developing the disease
In addition to these reasons, which can cause inflammation, there are also some risk factors. These include:
- Bacterial vaginosis, especially if no attempt is made to cope with it.
- Radiotherapy of the pelvic organs.
- Deformation of the uterus.
- Contraception, such as intrauterine device.
Modern drugs allow you to cope with inflammatory and infectious diseases, most importantly, that a woman should consult a doctor in time for appropriate help.
Symptoms of metroendometritis
Signs of manifestation of the disease may be different. If there is a chronic metroendometritis, the symptoms may be completely absent. The manifestation of the disease depends on the form and stage. Metroendometritis is characterized by an active phase, but there is also a period of remission.
Symptoms of chronic metroendometritis may not appear, especially if there are no symptoms of other inflammatory diseases of the uterus. During the period of exacerbation of metroendometritis, it is simply not impossible to notice this, as they appear:
- Lower abdominal pain.
- Pain during intercourse.
- Quite a painful menstruation.
During the examination, the gynecologist finds a seal and an increase in the size of the uterus. In the gynecological mirror, adhesions and ulcers on the mucous membrane are visible.
During remission, chronic metroendometritis manifests symptoms differently, but they must alert the woman and force him to see a doctor. These features include:
- Spotting from the uterus during the intermenstrual period.
- The monthly cycle is broken.
- Menstruation lasts a long time and is very painful.
- Purulent discharge.
- General weakness of the body.
- Periodic increase in body temperature.
Often women ask a gynecologist if it is possible to get pregnant after a chronic metroendometritis. If a woman is constantly undergoing treatment, and the disease is in the inactive stage, then there is a chance to get pregnant. But it is worth knowing that during the carrying may have its own certain difficulties.
To cope with any disease is not so easy. Chronic metroendometrit, the treatment of which is thorough and long, is not an exception. Therapy involves a comprehensive and phased approach. The treatment can be divided into the following steps:
- At first, the use of antibacterial drugs that will help neutralize the causative agents of the disease is important. The most commonly prescribed drugs are from the group of sulfonamides, for example, "Sulfadimethoxine", "Sulfalen", "Furadonin". It is possible to make even intrauterine infusion of drugs, it will give the most effective and rapid result. Also shown is the reception of immunostimulants that help the body cope with the infection. The most popular are "Kagocel", "Imudon", "Transfer Factor".
- The second stage of treatment includes:
- Drug metabolic therapy, it increases the supply of endometrium with oxygen and increases local immunity. Often used for these purposes "Actovegin", "Solcoseryl".
- Physiotherapy. Strengthen the blood supply, promote the resorption of adhesions. Shown: electrophoresis, infrared laser therapy, ultrasound therapy.
- Spa treatment.
Quite often, the treatment of the disease is also carried out with the help of hormonal preparations in order to restore the damaged endometrial mucosa. It has long been known that the amount and production of estrogen in a woman’s body affects not only her appearance, mood, and general condition, but also her reproductive health.
If the diagnosis is chronic metroendometritis, prescribing natural estrogens can also alleviate the patient's condition.
Natural estrogens - helpers for the female body
Natural estrogens are no worse than synthetic, able to restore the lack of hormones in the female body. There are a lot of products in which they are contained, here is a small list:
But most of these substances are contained in beer. It is under their influence that quite often men who abuse this drink acquire a beer belly. It is worth noting that beer from this point of view is dangerous for the male body, it can even provoke infertility, as the content of female sex hormones increases.
We were a little distracted by the stronger sex, but, returning to the beer, I must say that it is made on the basis of hop. The modern possibilities of the pharmaceutical industry make it possible to extract useful phytoestrogens from hops and produce medicines on their basis.
Acceptance of such drugs allows for a short period of time to restore hormones in the body. One such tool is Menomax.
In order for the chronic metroendometritic effects after itself not to leave the dire consequences, it is necessary to approach the treatment very seriously. The course of therapy must be completed completely, following all the recommendations of the doctor.
Causes of the disease
Taking into account many factors, specialists distinguish two etiological forms of the disease - infectious and aseptic. In most patients, the disease appears due to conditionally pathogenic flora or aerobic-anaerobic complexes. The most common infections, according to the results of microbiological research, are caused by:
- we flow,
- E. coli.
Polymicrobial associations (Staphylococcus aureus with enterobacteria) are detected in some patients with metroendometritis. In addition to non-specific microflora, during the study, mycoplasmas, diphtheria bacillus and gonococci can be detected.
Infection in most cases occurs ascending, that is, from the vagina and cervical canal into the uterine cavity. This is facilitated by gynecological manipulations:
- Childbirth. It should be clarified that after a cesarean section, the chance of infection is much higher than after childbirth, which is carried out naturally.
- The expansion of the cervical canal.
- Installing the intrauterine device (IUD).
- RDV (separate diagnostic curettage).
Sources of the descending drift of the causative agent of the disease are the fallopian tubes, the contact-inflammatory-modified appendix, and the hematogenous infection of the disease - distant purulent foci in the ENT organs.
Progress in metroendometritis of infectious etiology is facilitated by conditions that facilitate the penetration of microorganisms into the uterine cavity. These include:
- Uterine bleeding.
- Venous congestion in the pelvic cavity.
- Specific and non-specific colpitis.
The post-abortion type of the disease mainly occurs due to incomplete removal of the ovum. The reasons for the development of postpartum metroendometritis are the weakness of the labor activity, the prolonged anhydrous period, and the delayed residues of placental tissue in the uterine cavity. Aseptic type of pathology occurs against the background of various injuries and injuries of the uterus, mechanical or physical effects. Infectious inflammation in such cases occurs only secondarily.
Chronic metroendometrit. Symptoms of the disease depends on the nature of the inflammatory process and the factors of its appearance. At the first stage of development of pathology, women with suspicion of this disease complain of dull and aching pains that are localized in the lower abdomen, lack of appetite, drowsiness, severe disruptions in the menstrual cycle (menstruation becomes too abundant or, on the contrary, short), manifestations of infectious intoxication (nausea and vomiting).
During a thorough examination, the gynecologist notes a pathological enlargement of the uterus, a change in shape (if not treated in a timely manner, it becomes spherical), as well as marked pain on palpation. With the help of ultrasound (ultrasound), you can identify indirect signs of a chronic inflammatory process:
- Intrauterine synechia.
- The discrepancy between the thickness of the uterus phase of the menstrual cycle.
- The heterogeneity of the structure of the myometrium.
Acute metroendometritis: clinical manifestations of acute inflammation in most cases occur several days after abortion, childbirth, and various manipulations on the uterus.
The patient's condition begins to deteriorate rapidly: body temperature reaches 38-39 ° C, slight chilliness, severe malaise, tachycardia, symptoms of intoxication occur. In addition, patients have pain in the lower abdomen and in the sacrum, with palpation an increase in the uterus is found. For the acute type of the disease is characterized by turbid discharge - serous-purulent, in rare cases - with a putrid odor.
The presence of barriers to the outflow of purulent secretions from the uterine cavity is due to the appearance of pyometra. In such a situation, an exacerbation of the disease occurs, in which the patient's state of health worsens, there are cramping pain in the lower abdomen. With postpartum metroendometritis, lochia is delayed due to insufficient contraction of the uterus, its bending or clogging of the cervical canal with blood clots, progression of the lohiometer is possible.
The acute type of the disease lasts on average 5-10 days. The erased form flows together with subfebrile body temperature. In severe cases, the inflammatory process can spread to the pelvic peritoneum and serous cover of the abdominal cavity. The most unfavorable complications are gangrene of the uterus and blood infection.
Subacute metroendometrit. The main symptoms of the subacute stage of development of pathology: blood, purulent and mucous discharge. The pus in this form is much less when compared with the acute phase. Due to the weak manifestation of the manifestations of the disease, it can unnoticeably develop into a chronic form, the treatment of which is more difficult and takes longer.
Pain in the abdomen with subacute metroendometritis less intense and is characterized as pulling, which sometimes extends to the lumbar region and groin.
Another characteristic manifestation of the subacute stage is prolonged and abundant menstruation, in some cases, patients may even notice menorrhagia. With a particularly rapid progression of the disease, foci of inflammation contribute to the destruction of myometrial tissues, which leads to their replacement by connecting fibers.
Traditional medicine for the disease
Self-treatment of this disease with the help of folk remedies is extremely dangerous, because the lack of adequate antibacterial and hemostatic therapy leads to serious consequences, but during remission, doctors advise patients to use some recipes from alternative medicine.
- Hypericum 1 tbsp. l This plant should be poured with a glass of boiling water, and then left for 30 minutes on a steam bath. The resulting liquid should be filtered and consumed 50 g before a meal.
- Plantain. To make the drug from the plantain at home, it is necessary to chop the leaves of the plant and pour water so that 200 g of boiling water was 1 tbsp. l grass After cooking, the broth must be steeped for 2 hours. Take the tool should be 1 tbsp. l per day before meals.
- Honey. From this product you can make small candles to eliminate inflammation. For their preparation you need to mix 1 tsp. honey with chicken yolk and add a little flour so that the mass looks like dough. From the dough should make small candles and leave in the refrigerator. This tool is applied for 4 weeks, the candles are removed and replaced each time after a bowel movement.
Calendula. To make a special tincture from the flowers of this plant, 20 g should be poured with 70% ethyl alcohol solution, and then let the liquid stand in a place inaccessible to direct sun rays for 14 days. Cooked infusion is used for douching. Calendula can cause allergic reactions, so before applying it is necessary to make small samples in the wrist area. If within an hour redness was not observed, then the plant can begin to be used for its intended purpose.
Symptoms and treatment of metroendometritis largely depend on the form of pathology. The disease proceeds in several stages:
- The infection penetrates the organ cavity and affects only certain parts of the endometrium. Foci of inflammation in the uterus become red. The muscular layer has not yet been affected by pathogens.
- The inflammatory process spreads to the muscle layer, affecting the myometrium and nearby tissues.
- The infection spreads to the muscle layer, penetrates into the perimetry and parameter. The transition to the serous uterine layer is not excluded. Inflammation can occur in the peritoneal organs, the circulating tissue. To avoid such complications, you need to carefully monitor the symptoms and select the appropriate treatment.
The development of chronic metroendometrita is often asymptomatic. Among its main clinical manifestations are the following:
- uterine bleeding,
- secretion with a gray tinge, may be an admixture of pus,
- pain syndrome, localized in the sacrum and lower abdomen,
- increase in uterus size
- monthly cycle failure. They come irregularly and become excessively abundant,
- problems with conception and spontaneous miscarriages in the early stages.
Due to the onset of the inflammatory process, cysts and adhesions form in the cavity of the reproductive organ.
Once the infection has entered the uterine cavity, inflammation of the mucous membrane begins to develop - endometritis. Over time, the damaged mucosa loses its ability to retain pathogens, and they begin to penetrate deeper. As a result, the infection enters the muscular layer of the uterus causing such an inflammatory disease as metritis. At this stage, the clinical manifestations of metroendometritis become pronounced.
In a healthy woman, the uterus is reliably protected by such physiological barriers as the endometrium, the uterine glands, the cervical canal. Therefore, the risk of penetration of infection into the cavity is minimized.The development of pathology is possible with mechanical damage to the mucous membrane and failures in the immune system. That is why metroendometrit often develops after childbirth, abortion or gynecological operations.
In addition, to promote the penetration of infection deeper, perhaps, self-medication. An independent attempt to get rid of the disease leads only to alleviate the symptoms, but not to the destruction of the source of infection.
The inflammatory process with metroendometritis can be acute, subacute and chronic. In the first case, the clinical manifestations of the disease are quite bright and appear within 3-5 days from the moment of infection. The subacute form is distinguished by a more erased clinical picture, it is more difficult to diagnose and more often it indicates the presence of a chronic process.
The chronic form develops when the treatment of metroendometritis was not carried out in a timely manner. Symptoms in this case are practically absent, except for the moments of exacerbation of the disease.
Causes of metroendometritis
The only reason for the development of metroendometritis in the uterine cavity is infection. In medicine, the disease is usually divided into 2 types: specific and non-specific. In the first case, pathogenic microorganisms such as gonococci and trichomonads provoke inflammation. And in the second case, the infection develops due to streptococcus, staphylococcus, Escherichia coli and a number of other microorganisms. But there are also negative factors that at some point may contribute to the development of the disease. These include:
- Various injuries after diagnostic manipulations. Even a small wound in the uterine cavity can be an excellent breeding ground for bacteria.
- The consequences of abortion. During this procedure, the mucous is removed, in place of which an open wound surface is formed. And through the damaged vessels, microorganisms easily penetrate the muscle layer of the uterus. In addition, the accumulated blood in the absence of the mucous layer becomes an ideal place for the reproduction of bacteria.
- Introduction to the cavity of the intrauterine device. Microorganisms are able to penetrate through its threads.
- Promiscuous sex.
- Non-compliance with the rules of personal hygiene, especially in the postpartum period.
- Surgery in the uterine cavity.
- Not timely removed polyps. They delay uterine secretions, thereby forming a favorable environment for the reproduction of microorganisms.
Risk factors in the postpartum period are complicated protracted labor, poor labor, uterine bleeding, and remnants of placental tissue in the uterine cavity. Menstruation, bacterial vaginosis, colpitis, endocervicitis, and venous congestion in the pelvic organs can contribute to the development of metroendometritis.
Clinical manifestations of the disease
Symptoms of metroendometritis directly depend on the cause of its occurrence. But there are a number of common clinical manifestations. These include:
- failures of the menstrual cycle
- aching pain in the abdomen,
- symptoms of intoxication (nausea, vomiting).
During a gynecological examination, the doctor reveals a change in the size and shape of the uterus. Depending on the degree of inflammation, pain may be present on palpation.
The main symptoms of acute metroendometritis are severe pain in the pubic area, a sharp increase in temperature and the appearance of purulent discharge with a characteristic unpleasant odor. The acute form of the disease most often develops 3–5 days after intrauterine intervention (abortion, childbirth, spiral placement).
Symptoms of chronic metroendometritis include uterine bleeding, severe pain with pressure in the uterus and its significant increase in size. According to the observations of gynecologists, an indirect clinical manifestation of the disease can be considered any reproductive impairment in a woman. For example, the inability to conceive and miscarriages.
In the chronic form of the disease, menstrual dysfunctions such as the anovulatory cycle and menorrhagia are often observed. Companions of the chronic metroendometritis can be cysts, intrauterine synechiae, adhesions in the pelvic organs and chronic adnexitis.
In order to diagnose metroendometrit, the gynecologist firstly examines the uterus and vagina. Then the doctor writes out directions for laboratory and instrumental diagnostics:
- Blood test for the detection of leukocytes and ESR (erythrocyte sedimentation rate). Their increased number directly indicates the inflammatory process in the body.
- Ultrasound (ultrasound).
- Bakposev selections. It allows you not only to identify the causative agent of infection, but also to determine which antibiotic will be most effective during treatment.
- Vaginal smear examination helps assess the severity of the inflammatory process and microbial composition.
- Transvaginal Ultrasound. Using this method, you can understand the condition of not only the uterus, but also the other organs of the small pelvis.
Additional research methods may be needed to identify associated diseases in a patient. If the diagnosis of metrodometritis is difficult, then the doctor resorts to laparoscopy.
Women with suspected metroendometritis should be hospitalized urgently. The lack of timely treatment can provoke uterine bleeding and, as a consequence, death.
The basis of drug therapy in this case are antibacterial drugs. Before treatment, conduct a study on the sensitivity of the pathogen to the antibiotic. If such a procedure is not possible, the doctor prescribes a broad-spectrum drugs. One of the most common antibiotics for metroendometritis is penicillin. In case of intolerance to the drug at the discretion of the gynecologist, it is replaced by macrolides, tetracyclines or third-generation cephalosporins.
In any case, the doctor prescribes medications individually for each patient, sometimes it can be a whole group of medicines. The course of treatment lasts an average of 10-14 days. To remove toxins and pus accumulations, the uterine cavity is washed with antiseptics. Additionally, to strengthen the immune system prescribed intake of the vitamin complex.
Nonsteroidal anti-inflammatory drugs (ibuprofen, indomethacin) help to stop the inflammatory process in the uterine cavity. They not only relieve pain, but also reduce tissue swelling. After stopping the inflammatory process, the patient is prescribed a physiotherapeutic procedure. These include electrophoresis, phonophoresis, paraffin and laser therapy.
Remember, the resumption of sexual activity is possible not earlier than one menstrual cycle after the end of treatment. Such precaution is needed to fully restore the endometrium, otherwise the risk of re-infection is very high.
What is metroendometrit? This inflammatory disease of the muscular and epithelial layer of the uterus, resulting from the penetration of an infectious pathogen, which begins to develop rapidly under the influence of provoking factors.
Metroendometritis occurs due to injury of the uterine cavity. Violation of the integrity of the uterine layers (muscle and epithelial), the penetration of infection, the occurrence of tumors occurs in women in the following cases:
- Medical manipulations involving a curettage procedure, carried out for diagnostic or therapeutic purposes, carry high risks of infection in the uterine cavity.
- Abortion is an abortion procedure, during which the inner layer of the uterus is severely injured.
- Childbirth - the muscular uterine layer undergoes a series of changes during natural childbirth.
- The development of metroendometritis can lead to the presence of polyps on the walls of the uterus, which were not promptly removed. Such tumors disrupt the outflow of secretions from the uterine cavity, causing the pathogenic infectious microflora to accumulate, causing inflammation.
- Installation of vaginal barrier contraceptives.
- The development of sepsis.
Acute metroendometritis does not always occur after childbirth or curettage. It is all about the presence of provoking factors that increase the likelihood of the development of the inflammatory process of the layers of the uterine cavity. These include the following:
- the presence in the body of infectious foci localized in other internal organs,
- lack of personal intimate hygiene,
- development of diseases of immunodeficiency,
- having sex during menstruation,
- active intimate life with many partners
- diseases transmitted during unprotected sex,
- irradiation of the pelvic organs during radiation therapy,
- presence of bacterial vaginosis.
Symptoms of pathology
Symptoms of metroendometritis in the early stages of the development of the inflammatory process may be absent or may be mild. The expressed symptomatic picture is inherent in women with concomitant infectious or inflammatory diseases of the organs of the urogenital system.
The acute form and chronic metroendometritis are manifested by the following symptoms:
- lower abdominal pain
- severe discomfort during sex,
- increase in pain intensity during menstruation,
- failure of the menstrual cycle
- weakness and lethargy
- increased body temperature
- vaginal discharge.
The pain in the lower abdomen is dull, aching in nature, manifested by attacks. The intensity of the pain syndrome increases after physical activity, sexual intimacy. The body temperature rises periodically, the indicator is 37-37.5 °, which indicates the development of the inflammatory process in the body.
Problems with menstruation - profuse bleeding, severe, prolonged abdominal pain during menstruation - these are symptoms inherent in remission of chronic metroendometritis.
When an exacerbation occurs, a symptomatic picture of a general nature is manifested - pain, purulent vaginal discharge, poor health, fever.
Forms of inflammation
Depending on the causes of the occurrence and the nature of the symptomatic picture, an acute and chronic form of pathology is distinguished. Acute inflammation is characterized by a sudden appearance. A woman’s overall health is dramatically worsening, the temperature is rising, signs of intoxication are present. There is a pulling pain in the lower abdomen. The nature of the discharge - purulent, bloody.
If the disease was diagnosed before pregnancy, then after giving birth, the lochia, which should gradually decrease, on the contrary, increases, and the state of health sharply worsens.
Chronic metroendometritis occurs as a result of not completely treated acute inflammation. If at the onset of signs of the disease a woman does not respond to them and does not seek medical help, the acute form very quickly flows into the chronic stage. The chronic process is characterized by the total spread of inflammation with purulent foci.
Even in cases where a woman sought medical help in a timely manner, and the inflammation of the uterus was arrested, the chronic form of the disease may occur due to the fact that the root cause was not cured.
Subacute metroendometrit - borderline transformation of the acute stage of the disease into a chronic form. Characterized by an acute symptomatic picture. The danger of this condition lies in the fact that the symptoms of the disease disappear on their own within a few days, and the woman calms down, thinking that she has recovered.
The treatment of metroendometritis is carried out in a hospital inpatient setting. Therapy is complex, aimed at stopping the symptomatic picture and the treatment of the disease - the root causes of uterine inflammation. Treatment of the disease begins with the intake of antibacterial drugs in order to suppress the vital activity of pathogenic microflora and reduce inflammation more quickly.
Prescribed antibiotics have an extensive spectrum of action:
- the third generation of cephalosporins - Cefixime, Ceftriaxone,
- aminoglycoside group drugs - Amikacin, Netilmicin,
- antibiotics - macrolides - Spiramycin,
- penicillin group - Ampicillin, Tazobactam,
- fluoroquinolone antibacterial drugs - Ofloxacin.
What antibiotic drugs to use in the treatment of metroendometritis, the doctor decides, based on the results of blood tests and smears, the type of pathogenic microflora found in biological fluids.
In the case of a protracted course of the disease, the development of complications and a pronounced symptomatic picture, several drugs of the antibacterial spectrum of action can be assigned simultaneously.
3 days after the start of the course of treatment with antibiotics, repeated laboratory tests are carried out in order to track the positive dynamics from the prescribed treatment. Even if the symptoms and signs of metroendometritis decreased in the first 2 days after taking the medication, the treatment continues. The duration of the therapeutic course of antibiotics is from 10 to 14 days.
Therapy of metroendometritis also includes such a procedure as washing the uterine cavity with antiseptic spectrum preparations. This is necessary to wash out the pathogenic microflora from the organ and prevent the further spread of the inflammatory process.
Antiseptic washing of the uterus contributes to the relief of signs of general intoxication, while the woman’s well-being improves significantly. This type of therapy is not always prescribed, the doctor makes a decision on the expediency of this manipulation. Prohibited treatment of this method metroendometrita and during pregnancy.
Along with antibiotics, vitamins are prescribed. A high dosage of ascorbic acid, which strengthens blood vessels, and vitamins of group B is prescribed. Vitamin therapy is aimed at suppressing the negative effects of antibiotics on the gastrointestinal tract and strengthening the immune system so that the body can cope with pathogenic microflora.
After the symptomatic picture has been stopped, physiotherapeutic procedures are added to the drug treatment:
- laser therapy
- phonophoresis using hydrocortisone,
- electrophoresis with magnesium and potassium.
In the case when the disease proceeds with complications, which is observed in endometritis and other associated diseases, therapy is carried out with the infusion of medical solutions of detoxification spectrum of action. The purpose of this medical manipulation is to remove pathogenic microflora from the blood, to stop the inflammatory process quickly. If the development of metroendometritis is caused by a venereal disease, appropriate treatment is given to both partners.
To speed up the healing process and reduce the intensity of the pain symptom, a woman is prescribed non-steroidal anti-inflammatory drugs produced in the form of rectal suppositories - Ibuprofen, Indomethacin.
During treatment, it is necessary to refrain from sexual intercourse. You can have sex only after the end of menstruation, after the completion of the therapeutic course.
Knowing the danger of metroendometritis, what it is, and what causes the appearance of the inflammatory process of the muscular and epithelial layer of the uterus, we can distinguish a number of preventive measures, compliance with which will help to avoid the occurrence of this disease:
- Every woman should carefully observe intimate hygiene, it is necessary to wash, if possible, after each trip to the toilet.
- When having sex with an unfamiliar, untested partner, it is recommended to use a condom. Such a measure will help avoid infection with sexually transmitted diseases, against which metroendometritis often occurs.
- Considering the fact that the disease can not manifest itself as symptomatic for a long time, it is possible to make a diagnosis in time and carry out appropriate treatment only by undergoing a regular check-up at a gynecologist.
- It is necessary to visit a doctor and take tests once every 6 months. If a woman has a history of previously transferred inflammatory and infectious diseases of the genitourinary system, come for a check-up need more often.
- If a woman has established such a method of contraception as the uterine spiral, it is recommended to visit the gynecologist once in the first month after her installation, then once every 2-3 months, despite the absence of any alarming symptoms. The presence of an intrauterine device is a common cause of metroendometritis.
Chronic metroendometritis can cause a number of serious complications, cause infertility, provoke the development of inflammatory processes, up to peritonitis. Prevent the appearance of chronic inflammation in the uterine layer is possible only through timely diagnosis and proper treatment of the acute course of the disease.