How is endometritis diagnosed?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on January 17, 2025
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When suspecting endometritis in women, the first step is to inquire about the medical history. Most women exhibit abnormalities in their menstrual cycle, and some only show changes in the amount of menstruation. Ultrasound examination of the reproductive system shows no organic lesions, and the hormone panel is normal. During a gynecological examination, tenderness in the uterine body may be observed. Sometimes, ultrasound examination suggests that the endometrium is thin and uneven. Performing a hysteroscopy, localized hyperemia and edema of the endometrium can be seen, and diagnostic curettage plays a certain role in diagnosis.

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Written by Zhao Li Li
Obstetrics
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Can you get pregnant with endometritis?

Under normal circumstances, it is possible to become pregnant when suffering from inflammation of the endometrium. However, if an infection occurs due to the inflammation of the endometrium, it may affect the implantation of the fertilized egg. Therefore, during normal pregnancy, implantation might lead to poor embryonic development or cause a miscarriage. Therefore, once endometritis is confirmed, it is necessary to treat it promptly. Broad-spectrum antibiotics should be administered systematically before attempting to conceive normally. During pregnancy, it is also vital to closely monitor the condition of the endometrium. If continuous thickening of the endometrium occurs, it is crucial to take oral medication promptly to preserve the pregnancy and provide symptomatic treatment. (Medication should be used under the guidance of a doctor.)

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Written by Du Rui Xia
Obstetrics
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Can you get pregnant with endometritis?

When suffering from endometritis, it is not recommended to become pregnant during this time. It is better to wait until the endometritis is cured before trying to conceive. This is because endometritis can impact pregnancy. During the inflammation, a large number of white blood cells and macrophages appear on the surface of the endometrium, which can affect the vitality of sperm, leading to decreased sperm activity and even dead sperm, thus reducing the chances of pregnancy. Additionally, during endometritis, women may also develop anti-sperm antibodies, which hinder the implantation of the fertilized egg, preventing normal fertility. Therefore, it is advised for women to wait until after the endometritis is cured before trying to conceive.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Symptoms of endometritis discharge

When women develop endometritis, the severity of the condition varies depending on the type of bacteria involved, and the characteristics of vaginal discharge also differ. For example, some women may experience mild symptoms, primarily reflected in an increased amount of discharge. Others might have discharge mixed with blood streaks, and some women could have purulent discharge accompanied by an unpleasant odor. If the condition continues to progress, the discharge can become foul-smelling, increase in quantity, and show a significant infiltration of white blood cells. Some women may develop pus accumulation in the uterine cavity, resulting in the presence of purulent discharge.

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Written by Du Rui Xia
Obstetrics
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Causes of endometritis

Endometritis can be divided into tuberculous endometritis and non-tuberculous endometritis, with the latter being more common in clinical settings. Non-tuberculous endometritis is often caused by various pathogenic infections. It commonly occurs during menstruation, after a miscarriage, or during childbirth due to bacterial infections. For instance, inadequate sterilization during surgery, sexual activity during menstruation, and the retention of placenta or membranes after childbirth can all facilitate ascending infections.

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Written by Jia Rui
Obstetrics and Gynecology
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Can ultrasound detect endometritis?

Endometritis can be detected through an ultrasound, and it's best to inspect within three to seven days after the menstrual cycle has ended. Ultrasound is a tool that assists in diagnosing gynecological diseases, and it can be used to check for endometritis. However, to confirm the diagnosis, other methods such as laboratory tests, vaginal discharge exams, and internal scanning are needed. When treating endometritis, it's crucial to identify any underlying causes. For instance, if there are retained placental fragments after childbirth or a miscarriage, a curettage to remove the remnants is necessary. Furthermore, if the endometritis is caused by an intrauterine device, it should be removed; if caused by uterine polyps, these should be excised.