Postnatal parametritis

Postnatal parametritis is a result of the spread of infection (staphylococcus aureus, streptococcus, escherichia, etc.) by lymphogenous way from a postpartum ulcer or an infected uterus. Infections of the cervix and upper third of the vagina contribute to the penetration of pathogens into parametric fiber. Inflammatory effusion quickly becomes dense, which gives a characteristic consistency to the affected tissues.

Symptoms, course. The disease begins acutely at the 2nd week after childbirth, accompanied by a worsening of the general condition, chills, high fever, violation of urination. Endomiometritis often accompanies parametrite. Peritoneal symptoms are slightly or absent, since the inflammatory infiltrate is located extraperitoneally. The diagnosis is based on the clinical picture and the data of the vaginal examination. On the side of the uterus palpate a dense infiltrate (one or two-sided), reaching the walls of the pelvis. Differential diagnosis is performed with salpingo-oophoritis, pelvic peritonitis and metrotrombophlebitis.

Treatment. Bed rest, ice on the lower abdomen (in the early days), painkillers, antibiotics, sulfonamides; Corticosteroids (together with antibiotics) with delayed resorption of the infiltrate, iv administration of a 10% solution of calcium chloride. With suppuration of infiltrate, posterior colpotomy.