ENDOMETRITIS ETIOLOGY - DIAGNOSIS AND TREATMENT EXPERIENCE OF THE INSTITUTO-NACIONAL-DE-PERINATOLOGIA

Endometritis is one of the main causes of puerperal infection. To obtain information on the clinical characteristics, etiology, and evolution of this disease, a retrospective study was carried out involving patients who developed endometritis at the Instituto Nacional de Perinatologia from March 1, 1988 through May 31, 1991. During the 39 months included in the study, 180 cases were diagnosed, from which 150 medical records could be reviewed. In 92.6% of the patients, cesarean section was the resolution route of the pregnancy; 22% had a history of premature rupture of the membranes. The latency period for the development of postpartum endometritis was 120 +/- 66 hours, whereas in the post-cesarean-section cases it was 56.2 +/- 30 hours (P < 0.01). The most frequent symptoms were fever (100%), fetid lochia (65.3%), and pain on uterine mobilization (62.7%). The etiology of infection was characteristically polymicrobial, and the most frequently isolated bacteria were coagulase-negative Staphylococcus, Escherichia coli, and Peptostreptococcus sp. Bacteroides were mostly penicillin-resistant but sensitive to clindamycin. Two percent of the patients developed pelviperitonitis; one death occurred.