Female reproductive Flashcards
(3 cards)
Pathogenesis of endometriosis + most common site
Endometriosis is a condition characterized by the presence of endometrial glands and stroma outside the uterine cavity, most commonly on the ovaries. The tissue continues to respond to normal hormonal cycles, proliferating and shedding with each cycle.
However, lacking an outlet, this cyclic shedding leads to local inflammation, accumulation of blood, and formation of endometriomas—cystic ovarian masses filled with old blood. Chronic inflammation contributes to pelvic adhesions and fibrosis, often causing pain and infertility. Macrophages ingest the breakdown products like hemosiderin, appearing as hemosiderin-laden macrophages.
What is post-partum endometritis?
Postpartum endometritis is a polymicrobial infection of the uterine lining that occurs most commonly after a cesarean delivery.
Clinically, it presents with fever, lower abdominal pain, uterine tenderness, malodorous lochia (purulent vaginal discharge), and leukocytosis. If untreated, it can lead to peritonitis and sepsis due to spread of the infection.
What are the predisposing factors and pathophysiology behind postpartum endometritis?
Postpartum endometritis occurs when the normally sterile upper genital tract becomes contaminated with cervicovaginal flora during labor and delivery, especially in cases of prolonged labor or ruptured membranes. After a cesarean section, the risk increases due to foreign bodies like suture material and hematomas, which can serve as sites for polymicrobial infection. Additionally, suturing of the uterine incision may lead to myometrial necrosis, further predisposing the tissue to infection.
