Postpartum endometritis is an infection that can occur after you give birth—either in the lining of the uterus, known as the endometrium, or in the upper genital tract. It’s caused by bacteria already inside you before you went into labor or by bacteria introduced during childbirth.
The biggest risk factors
Between 5% and 7% percent of women develop postpartum endometritis after giving birth. While anyone can develop this condition, the rate of infection is 5-10 times higher in cesarean section (C-section) deliveries than vaginal deliveries, with unplanned C-sections having the highest incidence.
Beyond having a C-section, other risk factors include:
- Prolonged labor
- Prolonged rupture of the fetal membranes
- Infection during pregnancy
- Internal examinations during labor
- Postpartum hemorrhage
- Removal of the placenta by hand or incomplete removal
- Bacterial vaginosis (BV)
- Newborn stool inside the amniotic fluid
What to look out for
Most cases of postpartum endometritis are diagnosed within the first 10 days of giving birth, sometimes even while you’re still in the hospital. But in some cases, the condition can take up to six weeks to fully develop. Here are the signs and symptoms to watch for:
- A fever (most often within 72 hours after giving birth)
- A sore, tender, or swollen abdomen
- Pain while urinating or during sex
- Change in vaginal bleeding, either an increase or decrease
- Change in vaginal discharge, including a foul odor or discharge that looks like pus
- Feeling unwell or uncomfortable in general
- Headache
If you experience any of these symptoms, especially in combination with a fever, it’s important to contact your healthcare provider immediately. With prompt treatment, most people fully recover and have no lasting effects after the infection goes away.
If left untreated, however, postpartum endometritis can turn into sepsis, a potentially life-threatening condition in which the body overreacts to an infection. In some cases, scarring or damage of the reproductive organs is also possible. That’s it’s critical to make an appointment with your healthcare provider and get seen as soon as possible.
How it’s diagnosed and treated
To determine whether you have postpartum endometritis, your healthcare provider may:
- Ask you about your symptoms
- Conduct a physical exam
- Perform diagnostic tests (e.g., vaginal swab, blood test, and/or urine test)
If postpartum endometritis is confirmed, you’ll be treated with one or more antibiotics. Some of the most effective antibiotics used to treat this condition — commonly caused by group B streptococci and staphylococcus (staph) bacteria — include clindamycin, gentamicin, and ampicillin. However, your provider will use the best treatment for your individual needs.
These antibiotics are typically given with an IV, but in some cases, they may be given by injection. Regardless, the goal is to make sure the infection is fully cleared so that you can get back to taking care of your newborn and recovering from childbirth.
Reviewed by the Ovia Health Clinical Team
Sources:
- WebMD. What Is Postpartum Endometritis? Last Reviewed April 23, 2023. https://www.webmd.com/baby/what-is-postpartum-endometritis. Accessed July 20, 2024.
- Patient. Postpartum Endometritis. Patient.com, Last updated October 2, 2024, https://patient.info/pregnancy/postpartum-endometritis-leaflet
