Postpartum endometritis: Difference between revisions
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*Csection --> earlier endometrtitis | *Csection --> earlier endometrtitis | ||
==Work-Up== | == Work-Up == | ||
Fever or sepsis lab workup and cultures | |||
Pelvic Ultrasound | |||
- pelvic fluid collection | |||
- adnexal collection/hematoma | |||
CT AP if neg US and high suspicion | |||
- uterine fluid, debris and gas | |||
== DDx == | == DDx == | ||
Revision as of 08:55, 14 June 2011
Background
| RF (+no abx prophy) | Rate |
| Nonelective cesarean | 30% |
| Elective cesarean | 7% |
| Vaginal delivery | 3% |
Risk Factors
- Cesarean delivery (most important)***
- Prolonged labor
- Prolonged rupture of membranes
- Multiple cervical examinations
- Internal fetal or uterine monitoring
- Large amount of meconium in amniotic fluid
- Manual removal of the placenta
- Low socioeconomic status
- Maternal diabetes mellitus or severe anemia
- Preterm birth
- Bacterial vaginosis
- Operative vaginal delivery
- Postterm pregnancy
- HIV infection
- Colonization with group B streptococcus
Diagnosis
- fever
- uterine tenderness
- foul lochia
- mild vaginal bleeding
- NSVD --> late endometritis & polymicrobial
- Csection --> earlier endometrtitis
Work-Up
Fever or sepsis lab workup and cultures
Pelvic Ultrasound
- pelvic fluid collection
- adnexal collection/hematoma
CT AP if neg US and high suspicion
- uterine fluid, debris and gas
DDx
UTI/urosepsis
Intra-abdominal abscess
Septic pelvic vein thrombophlebitis
Pelvic DVT
Treatment
Insert
Disposition
Insert
Evidence Based Questions
Insert
See Also
Insert
Source
Adapted from ....(insert)