Which statement about postpartum endometritis is true?

Which statement about postpartum endometritis is true?

• A. It typically presents within 24-48 hours postpartum with fever and uterine tenderness and is treated with IV antibiotics.
• B. It is diagnosed by pelvic X-ray in most cases.
• C. It never occurs after vaginal delivery.
• D. It is prevented by prophylactic antibiotics during labor.

Answer: (A)

Postpartum endometritis is an infection of the uterine lining that usually emerges within the first couple of days after delivery. The classic picture is fever with uterine tenderness, often accompanied by foul-smelling lochia. Because it’s a surgical-tract–related infection involving the uterus and the lower genital tract, the standard treatment is prompt broad-spectrum IV antibiotics that cover both aerobic and anaerobic organisms—regimens commonly used are clindamycin plus gentamicin, with adjustments as needed. Diagnosis is clinical, based on fever and uterine tenderness, rather than imaging; pelvic X-ray isn’t used to make the diagnosis. It can occur after vaginal delivery, not just cesarean, and while giving prophylactic antibiotics during labor lowers the risk, it does not guarantee prevention.

Postpartum endometritis is an infection of the uterine lining that usually emerges within the first couple of days after delivery. The classic picture is fever with uterine tenderness, often accompanied by foul-smelling lochia. Because it’s a surgical-tract–related infection involving the uterus and the lower genital tract, the standard treatment is prompt broad-spectrum IV antibiotics that cover both aerobic and anaerobic organisms—regimens commonly used are clindamycin plus gentamicin, with adjustments as needed. Diagnosis is clinical, based on fever and uterine tenderness, rather than imaging; pelvic X-ray isn’t used to make the diagnosis. It can occur after vaginal delivery, not just cesarean, and while giving prophylactic antibiotics during labor lowers the risk, it does not guarantee prevention.