An infection of the lining of the uterus is called 'endometritis'. This type of infection may happen for around 1 to 3 % of woman after a vaginal birth, and 10 to 30% of women after a Caesarean birth. Other factors that can increase the likelihood of a uterine infection occurring can include the waters being broken for more than 24 hours, a long labour, and multiple internal vaginal examinations during the labour, retaining a part of the placenta or membranes in the uterus after the birth and interventions such as forceps or ventouse. Women who are anaemic are also at increased risk, because their resistance and immunity are lowered.
The signs of a uterine infection can include:
- A fever (above 38o Celsius) and a rapid pulse (above 100 beats per minute).
- Lower abdominal pain, with the uterus being tender to touch, when the belly is felt.
- The vaginal blood loss smelling offensive, or looking like it has greenish, yellow pus mixed with it.
- Possibly heavier bleeding.
- Possibly a headache, sweats and 'the shakes' (known as 'rigors').
Uterine infections can be caused by hospital acquired bacteria, or bacteria the woman is already carrying (such as gardnerella). However, it is often hard to pinpoint the actual bacteria causing the infection, because of the difficulty in taking a laboratory swab test of the inside of the uterus. It is believed that most cases of endometritis are caused by a combination of different bacteria.
Endometritis can be divided into 2 types:
- Early onset - Within 2 to 3 days of the birth. This is the most common type. OR
- Late onset - From 3 to 5 days, up to 6 weeks after the birth. This may be due to a small section of the placenta being left inside the uterus that slowly breaks down, and eventually causes a uterine infection. This is less common.