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Endometritis unrelated to pregnancy

Katherine T Chen, MD, MPH
Section Editor
Robert L Barbieri, MD
Deputy Editor
Sandy J Falk, MD, FACOG


Endometritis refers to inflammation of the endometrium, the inner lining of the uterus. Pathologists have traditionally classified endometritis as either acute or chronic. Acute endometritis is characterized by the presence of microabscesses or neutrophils within the endometrial glands, while chronic endometritis is distinguished by variable numbers of plasma cells within the endometrial stroma [1,2].

In the absence of a tissue sample, other factors can help distinguish between acute and chronic endometrial inflammation. Symptoms alone are not useful since the clinical manifestations of both disorders are similar (abnormal vaginal bleeding and pelvic pain). An exception is fever: patients with acute endometritis frequently have fever, while it is less common in women with the chronic process. Reviewing the clinical scenario is also helpful for determining whether endometritis is acute or chronic (table 1):

Acute endometritis in the nonobstetric population is usually preceded by pelvic inflammatory disease (PID) either secondary to a sexually transmitted infection or an invasive gynecologic procedure.

Chronic endometritis in the nonobstetric population can be due to a number of processes, including infections (eg, chlamydia, tuberculosis, other organisms related to cervicitis and PID), intrauterine foreign bodies or growths (eg, intrauterine contraception, submucous leiomyoma, polyp), and radiation therapy. No etiology is identifiable in approximately one-third of patients [3].

Endometritis unrelated to pregnancy will be discussed here. Endometritis in postpartum women is reviewed separately. (See "Postpartum endometritis".)

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Literature review current through: Oct 2017. | This topic last updated: Nov 08, 2017.
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