Postpartum endomyometritis.

Endomyometritis following parturition is a major cause of maternal morbidity. It is most common following cesarean delivery, especially in certain high-risk patient populations. The infection is usually caused by bacteria in the cervicovaginal tract that are inoculated into the uterus during labor and delivery. Both anaerobes and aerobes are thought to be involved in the disease process. A prompt diagnosis based on clinical suspicion, a thorough physical examination, and adjunctive laboratory measures is necessary to insure effective therapy and prompt resolution of the infection. The treatment consists of supportive care and broad-spectrum antibiotic coverage either with single extended-spectrum drugs or with combinations of antimicrobials. In cases appropriately treated, recovery without sequelae is the rule.