Postnatal metritis This is a deeper damage to the uterus, which extends beyond the endometrium due to the spread of infection through the lymphatic gaps and vessels in the myometrium.
Metrite begins simultaneously with the endometritis, and if there is its continuation, then not earlier than the 7th day after childbirth. The general condition deteriorates significantly, body temperature rises to 40 ° C, chills occur. Uterus is poorly contracted. With vaginal examination, the cervix is not formed even 9 days after delivery. At palpation, the uterus is painful, especially along the ribs. The discharge is small, they are dark red with an admixture of pus, with an unpleasant odor. The duration of the disease is 3-4 weeks.
Treat metritis by the same principles as the severe form of endometritis.
Pathological anatomy: inflammation of the cellulose located near the uterus, with lymphogenous spread of infection.
The disease begins on the 10-12th day after childbirth. Typical: fever, fever up to 39 ° C, rarely up to 40 ° C. Complaints to moderate, pulling pain in the abdomen. Severe pain occurs when the peritoneum is irritated. At the onset of the disease, an internal investigation determines the pastovy in the area of inflammation. After 2-3 days, the infiltration of the testate is clearly determined, and then of a dense consistency, moderately painful, immobile, located between the lateral surface of the uterus and the pelvic wall.
Treatment of parametrite
Treatment is carried out according to the general principles of the treatment of septic diseases. In case of acute parametery, antibiotics are prescribed with (taking into account an antibioticogram), infusion therapy, cold on the lower abdomen, vitamins. In severe course, combinations of two antibiotics are used, and in case of anaerobic etiology, metronidazole or lincomycin is additionally prescribed. Immunological reactivity stimulants, analgesics, and sedatives are also shown. With suppuration of the infiltrate - treatment operative: produce a colpotomy, and a T-shaped tube is inserted into the abscess cavity for aspiration-flushing drainage. After normalization of body temperature, resorption therapy and physiotherapy treatment are carried out.