Postpartum Endometritis

Postpartum endometritis occurs after vaginal delivery, cesarean delivery, or abortion resulting in the infectious inflammation of the inner lining of the uterus, the endometrium. It should be suspected in any postpartum patient presenting with fever, lower abdominal/pelvic pain, discharge, or lochia the first few days after giving birth. An emergency physician must recognize endometritis clinically but also evaluate for a urinary tract infection or retained products of conception which may have a similar clinical appearance. Most infections are polymicrobial but Streptococcus is frequently one of the bacterial offenders. Intravenous or oral broad spectrum antibiotics are necessary to promote adequate healing of the reproductive system to prevent future reproductive complications.