- Metritis reasons
- Metritis symptoms
- Treatment of a metritis
Metritis (metritis; from Greek - a uterus), a myometritis - an inflammation of a muscular layer of a uterus to which the endometritis precedes. The metritis can be an infectious and aseptic origin.
Most often is caused by staphylococcus, a streptococcus, colibacillus, Proteus, mycoplasmas, tuberculosis mycobacteria, a diphtheritic stick, anaerobic bacteria and it is quite frequent - microbic associations. Bacteria get preferential into a cavity of the uterus from a neck of uterus during periods, at abortion or pathological childbirth. Development of a metritis in labor is promoted: long anhydrous period, weakness of patrimonial activity, bleeding; out of pregnancy — overcooling, the wrong position of a uterus, a congestive plethora.
The metritis can arise at use of intrauterine contraceptives, penetration of an infection from an appendix, at damage of uterine tubes tuberculosis, and also in a hematogenous way at infectious extragenital diseases. The metritis aseptic happens at uterus bruises, at introduction to her cavity of various chemicals.
Distinguish an acute and chronic metritis. In the acute period there are a thickening, a loosening, swelled, the myometrium hyperemia, and an endometria becomes covered by a purulent plaque. At microscopic examination in myometriums infiltration is observed by segmentoyaderny leukocytes, lymphocytes; in an endometria dystrophic change of glands, the exfoliating of an epithelium leading to formation of ulcers of an endometria, sometimes with formation of granular fabric is noted. The postabortion metritis arises mainly in a zone of the remains of fetal egg; at a puerperal metritis the inflammation arises in the field of a decidua in the beginning, then extends to a muscular layer which becomes edematous, infiltrirovanny leukocytes and lymphocytes.
Process can sometimes pass to a serous cover of a uterus with development of a perimitritis and pelviperitonitis. At a chronic current decrease a hyperemia and swelled, in infiltrate prevail lymphatic and plasmocytes, appear the ksentomny and lozhnodetsidualny cells differing from true, found at pregnancy, the smaller maintenance of a glycogen. At the heavy course of a metritis there comes the atrophy of slime layer of a uterus with a hyalinosis of blood vessels, with the subsequent development of an amenorrhea, anovulation and hypo-ovaria.
The tubercular acute metritis arises on 3 more often — the 4th day of a postabortion or puerperal period, is characterized by fervescence, a bad general state, pains in the bottom of a stomach, is frequent with irradiation in a sacrum. The uterus is increased in a size, a soft consistence, is painful. purulent discharges, sometimes putrefactive character, involution of a uterus is slowed down. At a chronic metritis the uterus is a little increased in a size, dense, painless, allocations from a uterus have serous character. Disturbance of periods in the form of uterine bleedings and intermenstrual bleedings is often observed, anovulatory cycles, inflammations of appendages of a uterus sometimes appear.
Treatment of a metritis:
At an acute metritis are shown — the bed rest, cold on a stomach bottom reducing a means uterus (oxytocin, Pituitrinum, Praegnantolum a hydrochloride), antibiotics (semi-synthetic penicillin, drugs of a broad spectrum of activity, cephalosporins, further — antibiotics taking into account sensitivity of microflora are most reasonable in the beginning), soothing.
In the presence of the symptoms indicating a delay in a cavity of the uterus of elements of fetal egg (bleeding, data of ultrasonography, colicy pains) their removal by means of a vakuumekskokhleation or a careful scraping of a mucous uterus is shown. At a chronic metritis appoint treatment physical methods (an electrophoresis with iodine, salts of magnesium, zinc, ultrasound, a diathermy, mud cure, an ozoceritotherapy), at disturbance of menstrual function - hormonal therapy. Prevention: rational conducting childbirth, the prevention of penetration of pathogenic microbes into a cavity of the uterus at artificial abortion and introduction of an intrauterine spiral.