- Endomiometrit's symptoms
- Endomiometrit's reasons
- Endomiometrit's treatment
Endomyometritis (Greek endu inside + mys, myos a muscle – mztra a uterus + - itis; a synonym a metroendometritis) — an inflammation of mucous and muscular covers of a body of the womb.
Distinguish an acute and chronic endomyometritis. The acute endomyometritis arises on 3 more often — the 4th day after the delivery or abortion. Its development is promoted by existence in a uterus of clots, the remains of fetal egg and a decidua. The disease begins with increase температуря bodies to 38 — 38,5 ° and a fever (pulse becomes frequent according to temperature). Patients complain of pains in a stomach bottom, weakness, a headache, a loss of appetite. Allocations from a genital tract become muddy and quite often get a putrefactive smell, At a vulval bryushnostenochnom a research the soft, edematous uterus, painful in side departments is palpated. The sizes exceed it usual (uterus subinvolution). The delay of allocations in a cavity of the uterus (in a puerperal period the lohia serosa develops) with the subsequent suppuration is possible. Sometimes inflammatory process extends to all layers of a uterus, including serous (metritis) that is followed by an aggravation of symptoms of the patient. When using antibiotics the clinical picture of an acute endomyometritis can be erased.
The chronic endomyometritis is characterized mainly by light serous allocations from a genital tract, cyclic uterine bleedings — menorrhagias. The uterus is slightly increased, dense, painless. At a tubercular endomyometritis which has a chronic current and often is followed by damage of uterine tubes the leading symptoms are infertility and disturbance of a menstrual cycle on type of an amenorrhea, oligomenorrhea, etc. The gonorrheal endomyometritis can proceed both sharply, and chronically, it is accompanied by other symptoms of gonorrhea.
At an endomyometritis uterus appendages, a peritoneum of a small pelvis, a parametrium — the cellulose located between leaves of wide ligaments of uterus (parametritis) can be involved in pathological process. Development of a parametritis is promoted by side ruptures of a neck of uterus at the time of delivery or at an abortion, fusion of the infected blood clots in parametrium vessels at a puerperal or postabortion endomyometritis.
The acute parametritis proceeds hard, is followed by intoxication phenomena, fervescence to 38 — 39 °, pains in a stomach bottom. In case of lack of adequate treatment within 5 — 10 days abscess of a parametrium which sometimes is independently opened in a rectum, a vagina or a bladder can be formed, is more rare — in an abdominal cavity or in a cavity of the uterus. At a gynecologic research define painful tugoelastichesky or dense infiltrate sideways or behind from a uterus, displacing it to the opposite side, and reaching basin walls; at suppuration in it reveal the softening centers. Gradually acute phenomena abate (a subacute parametritis), in the absence of treatment process can accept a chronic current. The non-constant aching pains in a stomach bottom, the wrong position of a uterus owing to development of commissures and deformation of the copular device of a uterus are characteristic of a chronic parametritis. Periodically there are aggravations of inflammatory process.
Results from penetration into a uterus of pathogenic microorganisms: streptococci, stafilokokk, gonokokk, colibacilli, mycobacteria of tuberculosis, trichomonads, bacteroids, chlamydias, viruses, etc. Infection can come in the ascending way (from a vagina, the channel sheikhs of a uterus), gematogenno and limfogenno. Contagiums can get to a cavity of the uterus from the outside — at non-compliance with rules of an asepsis and antiseptics during intrauterine diagnostic and medical manipulations. More often E. develops after the delivery, abortion. Usually in the beginning there is an inflammation of a mucous membrane of a uterus (endometritis), then, as a rule, the muscular coat is involved in pathological process.
Treatment is carried out in a hospital. At an acute endomyometritis the bed rest, prescription of antibiotics (depending on a type of the activator), soothing and spasmolytic drugs are recommended. If the effect of therapy is absent, washing of a uterus is shown by solutions of antiseptic agents (for example, Aethacridinum of a lactate, a dioxidin) in case of a delay in a cavity of the uterus of clots, the remains of fetal egg or a decidua conduct a tool research of a cavity of the uterus, removal of the elements which were late in it and washing of a uterus antiseptic solutions. At development of an acute parametritis along with antibacterial carry out infusional therapy (реополиглюкин, Polyglucinum, albumine, a protein), appoint the vitamins and means strengthening an immune responsiveness of an organism. Abscess of a parametrium is opened after its preliminary puncture, in modern conditions it can be carried out under ultrasonography control. Apply a diathermy, mud cure, an ozoceritotherapy and a paraffin therapy to treatment of chronically current endomyometrites and a parametritis, acupuncture. A gonorrheal and tubercular endomyometritis treat according to the general principles of therapy of gonorrhea, tuberculosis. The forecast at timely and adequate therapy favorable.