Puerperal endometritis sounds très technique, pourtant derrière ce terme se cache une situation très concrète pour les jeunes parents : une infection de l’utérus qui survient après la naissance. Vous venez de donner la vie, votre corps se réorganise à une vitesse impressionnante, et soudain la fièvre apparaît, les douleurs augmentent, les saignements changent d’odeur… Faut‑il s’inquiéter ? Est‑ce “normal” ou le signe que quelque chose ne va pas ?
L’objectif ici est simple : vous aider à faire la différence entre un retour de couches habituel et une puerperal endometritis qui nécessite une prise en charge médicale rapide, expliquer les mécanismes en jeu, détailler les symptômes à surveiller, les traitements possibles, et la façon dont vous pouvez continuer à vous occuper de votre bébé tout en prenant soin de votre santé.

what puerperal endometritis means after birth

Puerperal endometritis corresponds to an infection of the inner lining of the uterus (the endometrium) that appears during the postpartum period, usually in the first 6 weeks after birth. In more everyday language, it is a postpartum uterine infection.

During pregnancy, the uterus is a kind of “nest” with a rich blood supply, membranes and the placenta. After birth, this whole system is dismantled très rapidement. The placenta detaches and leaves a large raw area inside the womb. The cervix, which has been widely opened to let the baby pass, stays partially open for a while. Lochia – the postpartum blood and discharge – flows through this channel.

In this context, bacteria that usually live in the vagina or sometimes in the intestine can move upwards through the cervix and settle on this inner wound. That is puerperal endometritis: an ascending polymicrobial infection of a uterus that has just been pregnant.

You might wonder: “Did I catch something from outside?” In reality, the germs most often come from your own vaginal microbiota and nearby intestinal flora. They are usually harmless where they normally live, but can cause problems when they reach the placental site.

Most women with puerperal endometritis:

• Develop symptoms between day 2 and day 10 postpartum (very often around days 3–5).
• Notice fever plus pelvic pain and abnormal lochia.
• Improve clearly within 24–72 hours once broad‑spectrum antibiotics are started.

It is a frequent cause of postpartum fever, especially after cesarean birth, but with prompt care, the outcome is generally favourable.

how common puerperal endometritis is

The frequency of puerperal endometritis strongly depends on the type of birth and on obstetric practices.

• After an uncomplicated vaginal delivery, the risk is relatively low, around 1%.
• After a scheduled cesarean section done before labour and before rupture of membranes, the rate is higher, around 3%.
• After an emergency cesarean performed during labour or after prolonged rupture of membranes, the risk rises to 5–10%.

Why such a difference? Several elements interact:

• The longer the labour, the more vaginal examinations and procedures.
• Once the waters have broken, germs can reach the uterine cavity more easily.
• A cesarean involves an incision in the uterus and sometimes a small haematoma near the scar, creating a favourable environment for bacteria.

These numbers also vary between hospitals and countries according to:

• Access to effective antibiotic prophylaxis before cesarean.
• Quality of aseptic technique during childbirth.
• Availability of staff and equipment for safe care.

Even if puerperal endometritis is usually well controlled with treatment, it remains one of the main reasons for postpartum readmission to hospital, which means more stress, more fatigue, and sometimes unexpected separation from home and family organisation.

causes and mechanisms: what happens in the uterus

After birth, the uterus is both powerful and vulnérable. It contracts strongly to limit bleeding, yet internally it presents a large wound: the placental bed.

Several elements explain why puerperal endometritis can appear:

• The placental site behaves like a big internal scab: it contains blood clots, necrotic tissue and lochia.
• The cervix is still open enough for germs to enter.
• The membranes (the “pouch of waters”) are no longer there to act as a barrier.
• If any retained products of conception (small pieces of placenta or membranes) remain, they can act like a nutrient‑rich “nest” for bacteria.
• After cesarean, a uterine incision and possible haematoma create additional weak points.

Puerperal endometritis is typically:

• Ascending: germs go upwards from the lower genital tract.
• Polymicrobial: several types of bacteria act together rather than a single pathogen.

typical germs involved

The germs most often implicated are part of the normal flora of the vagina and intestine:

• Anaerobes (thrive without oxygen): Bacteroides, Prevotella, Peptostreptococcus.
• Aerobic gram‑positive cocci: Group A Streptococcus, Group B Streptococcus, Enterococcus, some Staphylococcus.
• Gram‑negative bacilli: Escherichia coli, Klebsiella, Proteus.
• Genital mycoplasmas: Ureaplasma urealyticum, Mycoplasma hominis.

This diversity explains why treatment relies on broad‑spectrum therapy, often combining drugs covering:

• Gram‑positive and gram‑negative bacteria.
• Aerobes and anaerobes.

what does not cause puerperal endometritis

Many parents worry that an everyday gesture has triggered the infection. In practice, puerperal endometritis is not caused by:

• Breastfeeding or skin‑to‑skin contact.
• Gentle walking once your care team has said it is safe.
• Taking a shower with standard hygiene.
• Holding, rocking or comforting your baby.

The main drivers are obstetric and medical: duration of labour, rupture of membranes, type of birth, pre‑existing genital infections, maternal health (for example diabetes or anaemia), and the need for procedures such as manual removal of the placenta.

Developing puerperal endometritis does not indicate poor hygiene or something “done wrong”. It reflects a combination of biological factors and circumstances around the birth.

risk factors parents may hear about

Professionals often talk about “risk factors”. This does not mean that a problem was inevitable, but that the context made infection more likely.

labour and birth related factors

Some situations increase the risk of puerperal endometritis:

• Cesarean delivery, especially after labour has started.
• Prolonged labour with several vaginal examinations.
• Prolonged rupture of membranes (waters broken for many hours).
• Internal fetal monitoring (scalp electrode, intrauterine catheter).
• Instrumental vaginal delivery (forceps or vacuum).
• Chorioamnionitis (infection of membranes and amniotic fluid during labour).
• Manual removal of placenta or uterine revision.
• Severe postpartum haemorrhage.
• Retained placental fragments.

Each vaginal examination, even when performed very carefully, slightly increases the chance that bacteria move upwards. The longer this situation persists, the more time germs have to colonise the uterus.

A cesarean performed at the end of a long labour cumulates several elements: rupture of membranes, repeated exams, internal devices, surgical incision in the uterus. This combination explains why emergency cesarean carries a higher risk than elective surgery.

maternal health and environment

The mother’s general condition also plays a role:

• Anaemia reduces oxygen transport and can weaken immune responses.
• Poorly controlled diabetes affects white blood cells and wound healing.
• Obesity modifies tissue perfusion and increases postoperative infection risk.
• Smoking alters microcirculation and natural defences.
• Pre‑existing bacterial vaginosis or sexually transmitted infections increase the amount of potentially aggressive bacteria in the vagina.
• Social factors (distance from care, financial difficulties, limited prenatal follow‑up) can delay diagnosis and management.

A balanced vaginal microbiota, rich in protective lactobacilli, usually helps prevent ascending infections. When this balance is disturbed – for example by bacterial vaginosis – harmful bacteria can become more dominant and reach the uterus more easily during labour.

signs and symptoms to recognise

You may ask yourself: “How do I know whether my pain and bleeding are normal or not?” Puerperal endometritis often appears between postpartum day 2 and day 10 and associates several features.

Core signs are:

• Fever ≥ 38.0°C (100.4°F), persistent or recurring.
• Uterine or fundal tenderness when the top of the uterus is pressed.
• Lochia that becomes foul‑smelling, unusually coloured, or suddenly heavier.

Additional symptoms may include:

• Lower abdominal or pelvic pain, more constant than typical cramps.
• General malaise, chills, headache, feeling “flu‑like”.
• Fast heart rate.
• Uterus that seems slow to shrink (subinvolution).

what you may notice at home

Typical home observations in puerperal endometritis:

• A new fever appearing 2–5 days after birth, or a fever that returns after having gone down.
• Pain in the lower belly that no longer follows the feeding rhythm and instead remains almost continuous.
• Lochia that:
• Smells strongly unpleasant or “rotten”.
• Changes suddenly in colour (for example brown‑green) or quantity.
• Becomes heavier again after a period of decrease.
• Marked fatigue, dizziness or a feeling of being “very unwell” combined with pelvic pain.

Any combination of these warrants a call to a midwife, obstetrician or emergency department, especially in the first two weeks postpartum.

normal recovery versus warning signs

Some discomfort is expected while the uterus returns to its pre‑pregnancy size:

• Lochia:
• First days: red, like a moderate period (lochia rubra).
• Then: pink or brownish (lochia serosa).
• Later: whitish or yellowish with decreasing volume (lochia alba).
• A mild “blood‑like” smell is normal. Very strong, putrid odour is not.
• Afterpains (postpartum cramps) intensify during breastfeeding because oxytocin makes the uterus contract, but they should gradually become less frequent and less intense.

In puerperal endometritis, by contrast:

• Pain is more constant and uterus is sharply tender on touch.
• Fever persists or returns.
• Bleeding pattern or smell changes unexpectedly.

A single moderate fever peak after a very long labour or dehydration can happen and may not indicate infection. What matters is persistence, association with other symptoms and overall condition.

red flags and when to seek urgent care

Some signs suggest that the situation requires rapid medical attention, without waiting to “see if it passes”.

Urgent assessment is needed if you notice:

• High or persistent fever, not relieved by usual painkillers or rest.
• Increasing, intense abdominal pain, a belly that becomes very hard or painful on palpation.
• Strong chills, rapid breathing, confusion, extreme weakness – possible indicators of sepsis.
• Heavy vaginal bleeding, large clots or sudden increase in blood loss after improvement.
• New redness, warmth, discharge, or opening of a cesarean or perineal wound.
• Chest pain, shortness of breath, calf pain or swelling – signs that may suggest deep vein thrombosis or pulmonary embolism.

In case of:

• Feeling faint with heavy bleeding,
• Difficulty staying awake,
• Very fast breathing,
• Cold, clammy skin,

emergency services should be contacted immediately. These symptoms can indicate shock and must be treated without delay.

how puerperal endometritis is diagnosed

Puerperal endometritis is mainly a clinical diagnosis, meaning that the doctor relies on your symptoms, your story around the birth and the physical examination.

history and examination

The assessment usually includes:

• Details of the birth:
• Duration of labour.
• Time between rupture of membranes and delivery.
• Type of birth: vaginal, planned cesarean, emergency cesarean.
• Use of forceps, vacuum, manual removal of placenta or internal monitoring.
• Personal risk factors:
• Diabetes, obesity, anaemia, smoking, previous pelvic infections.
• Timing:
• Exact day postpartum when fever and pain started.
• Evolution of symptoms since then.

On examination, the clinician:

• Palpates the abdomen and performs a bimanual exam (one hand inside the vagina, one on the abdomen) to evaluate:
• Size and position of the uterus.
• Degree of uterine tenderness.
• Observes lochia: colour, odour, quantity, presence of clots.
• Inspects scars: cesarean incision, episiotomy or tear repair.
• Evaluates vital signs: blood pressure, pulse, temperature, respiratory rate, oxygen saturation.

laboratory tests and imaging

To support the diagnosis and rule out other causes of postpartum fever, tests often include:

• Complete blood count (CBC): looks for high white blood cell count.
• C‑reactive protein (CRP) or other inflammatory markers: help monitor evolution.
• Urinalysis and urine culture: urinary infection is another frequent postpartum problem.
• Blood cultures when sepsis is suspected, before starting antibiotics.

Imaging is not always necessary. A pelvic ultrasound is helpful when:

• Bleeding is particularly heavy or unusual.
• There is suspicion of retained products, haematoma or pelvic abscess.
• Fever persists beyond 48–72 hours despite treatment.

If the clinical picture is severe or atypical, CT scan or MRI can explore:

• Pelvic abscess.
• Ovarian vein thrombosis.
• Appendicitis or other abdominal emergencies.

how doctors assess severity and decide on hospital care

Not all puerperal endometritis cases need the same intensity of care. Health professionals distinguish:

• Uncomplicated endometritis:
• Fever and uterine tenderness.
• No signs of organ dysfunction.
• No suspicion of abscess or retained products.
• Complicated infection:
• Sepsis, pelvic abscess, peritonitis.
• Suspected septic pelvic thrombophlebitis (infected clot in pelvic veins).
• Retained products or severe bleeding.

They also consider:

• Mode of delivery (infection after cesarean often requires closer monitoring).
• How rapidly symptoms appeared.
• Pre‑existing conditions (heart disease, severe anaemia, diabetes).
• Possibility of safe follow‑up at home (distance from hospital, social support, childcare).

Hospital admission is frequently proposed when:

• Fever is high or persistent.
• There are signs of sepsis or low blood pressure.
• The infection follows a cesarean section.
• There is concern about an abscess or thrombosis.
• Outpatient follow‑up would be difficult or unsafe.

treatment: antibiotics, comfort and monitoring

Once puerperal endometritis is suspected, treatment should start quickly, usually without waiting for all test results.

inpatient antibiotic regimens

In hospital, the classic regimen combines:

• Clindamycin IV: very effective against anaerobes and many gram‑positive bacteria.
• Gentamicin IV: an aminoglycoside targeting gram‑negative bacilli like E. coli.

This combination matches the polymicrobial nature of puerperal endometritis and is widely recommended by obstetrics and infectious disease societies.

If there is suspicion of Enterococcus infection, or if the response is incomplete after 24–48 hours, doctors may add ampicillin. Alternative options include:

• Ampicillin–sulbactam.
• Piperacillin–tazobactam.
• Third‑generation cephalosporins associated with metronidazole for anaerobic coverage.

Intravenous treatment is usually maintained until:

• Fever has disappeared for at least 24–48 hours.
• Pain and general condition clearly improve.

After that, a step‑down to oral antibiotics completes a total of about 7–10 days, adapted to the individual case.

outpatient treatment for mild cases

For selected women after vaginal birth, when:

• Fever is moderate.
• There is no sign of sepsis.
• Access to care is easy.

Doctors may propose initial management at home with oral antibiotics, for example:

• Amoxicillin‑clavulanate, which covers many gram‑positive, gram‑negative and anaerobic germs.
• Clindamycin plus metronidazole in case of penicillin allergy.

Close follow‑up is essential: if fever or pain does not decrease within 24–48 hours, reassessment is needed.

pain relief and supportive care

Alongside antibiotics, several measures help the body recover:

• Paracetamol and ibuprofen to control fever, uterine cramps and headaches.
• Adequate hydration to support circulation and kidney function (important with gentamicin).
• Iron‑rich and protein‑rich foods to rebuild blood reserves and aid wound healing.
• When mobility is reduced, venous thromboembolism prophylaxis (compression stockings, low‑dose heparin) may be used, especially after cesarean.

Most mothers treated for puerperal endometritis can continue breastfeeding. The majority of antibiotics used have been studied in lactation and are considered compatible. Professionals may monitor the baby for mild diarrhoea, rash or unusual irritability, but significant complications are rare.

when treatment seems not to work

Occasionally, fever or pelvic pain persists beyond 48–72 hours, even with appropriate therapy. This situation deserves a new evaluation.

Doctors may then:

• Re‑examine the uterus and scars to check for new signs.
• Verify that dosage and spectrum of antibiotics are adequate.
• Order pelvic ultrasound to look for:
• Retained placental fragments.
• Haematoma.
• Pelvic abscess.
• Request advanced imaging (CT, MRI) if they suspect:
• Septic pelvic thrombophlebitis.
• Ovarian vein thrombosis.
• Peritonitis or another abdominal infection.

Management is then adjusted:

• If retained products are present, a uterine evacuation (suction or curettage) may be needed.
• If an abscess is detected, image‑guided drainage can be performed.
• In septic pelvic thrombophlebitis, treatment usually combines continued antibiotics and anticoagulation with heparin.

Exceptionally, in life‑threatening sepsis that does not respond to intensive care and antibiotics, a hysterectomy can be proposed as a last resort to save the mother’s life. This situation remains rare but can be very emotionally challenging, which is why early diagnosis and treatment of puerperal endometritis are so important.

puerperal endometritis after cesarean birth

After cesarean birth, puerperal endometritis tends to:

• Occur more often.
• Appear earlier.
• Sometimes combine with wound infection.

Parents and professionals monitor:

• Fever and uterine tenderness.
• Pain near the uterine incision, sometimes radiating to the flanks.
• Aspect of the abdominal scar:
• Redness, warmth, swelling.
• Oozing, pus or unpleasant odour.
• Partial opening of the wound.

Because the infection can spread around the incision or into deeper pelvic spaces, doctors more readily use ultrasound or CT scan after cesarean to check for haematoma or abscess.

Treatment principles remain similar (broad‑spectrum antibiotics, supportive care), but IV therapy may be longer, especially if a collection of pus or a large haematoma is present.

scar care at home

Once back home, simple habits promote good healing:

• Keep the scar clean and dry, pat gently after showers rather than rubbing.
• Avoid tight clothing that irritates the incision line.
• Observe the wound once a day:
• Is redness increasing?
• Is pain becoming sharper instead of milder?
• Any discharge or bad smell?
• Follow your team’s instructions about dressings and bathing.

A sudden peak of pain at the scar, new swelling or discharge with odour merits medical review, even if you do not have a high fever.

possible complications and long‑term outlook

Untreated or severe puerperal endometritis can spread beyond the uterus. Possible complications include:

• Sepsis and septic shock.
• Pelvic cellulitis (infection of tissues around the uterus).
• Peritonitis (infection spreading inside the abdominal cavity).
• Pelvic abscess.
• Septic pelvic thrombophlebitis or ovarian vein thrombosis.
• Prolonged hospital stay and delayed recovery.

In the short term, new symptoms to watch for are:

• Sharp, localised abdominal pain rather than diffuse cramping.
• Persistently high fever despite adequate treatment.
• Nausea, vomiting, abdominal distension.

When puerperal endometritis is treated promptly, long‑term complications remain rare. Most women recover completely and have normal fertility.

fertility and future pregnancies

The uterus has a remarkable capacity to heal. In the majority of cases:

• Menstrual cycles return to their usual pattern.
• Subsequent pregnancies evolve normally.
• There is no increased risk of infertility.

Risks to fertility increase when puerperal endometritis is:

• Very severe.
• Associated with repeated curettage or intrauterine procedures.
• Complicated by adhesions in the cavity (Asherman’s syndrome) or tubal damage.

Warning signs that deserve specialist assessment later include:

• Very light or absent periods after the postpartum period.
• Difficulty conceiving.
• Repeated miscarriages.

A hysteroscopy (camera inside the uterus) or specific imaging can be proposed in these cases. Many women, even after a complicated infection, go on to have wanted pregnancies with specific monitoring adapted to their history.

prevention strategies before and after birth

You cannot control every parameter of birth, but certain strategies reduce the risk of puerperal endometritis.

what healthcare teams do

Healthcare professionals can:

• Give prophylactic antibiotics before cesarean (often weight‑based cefazolin, sometimes with azithromycin in non‑elective surgery).
• Use vaginal antiseptic preparation before cesarean to lower bacterial load.
• Limit the number of vaginal examinations to what is strictly necessary.
• Reserve internal fetal monitoring for situations where benefits clearly outweigh risks.
• Detect and treat chorioamnionitis rapidly during labour.
• Respect strict aseptic technique during procedures.

During pregnancy, they can:

• Screen and treat urinary tract infections, bacterial vaginosis and STIs.
• Address anaemia, encourage smoking cessation, support balanced nutrition and good glucose control.

After birth, close observation of temperature, pulse, lochia and pain allows early identification of puerperal endometritis and rapid initiation of treatment.

what parents can do

Parents can support prevention and early detection by:

• Attending antenatal appointments and recommended tests.
• Informing professionals about any history of pelvic infection or significant health problem.
• Practising gentle wound hygiene:
• Clean hands before touching pads or scar.
• No aggressive products or internal douches.
• Observing their own signals: fever, unusual odour, growing pelvic pain, breathing difficulty.

The aim is not to create hypervigilance, but rather a quiet familiarity with what is expected during recovery so that changes become noticeable.

maternal and newborn wellbeing during puerperal endometritis

Managing puerperal endometritis means caring for physical health, but also for emotional balance and the newborn’s routine.

breastfeeding and antibiotics

Most antibiotics used to treat puerperal endometritis – such as amoxicillin, many cephalosporins, metronidazole or clindamycin – are considered compatible with breastfeeding. Only traces reach the baby through milk, and serious effects are uncommon.

Some babies may show:

• Slightly looser stools.
• Mild rash.
• Transient fussiness.

If you notice persistent diarrhoea, blood in stools, intense thrush or extreme sleepiness, talking to a paediatrician is wise. Adjustments can be made if needed, but the goal is usually to maintain breastfeeding whenever the mother wishes to continue.

Comfortable positions can help:

• Side‑lying breastfeeding to spare the abdomen after cesarean.
• Semi‑reclined positions with cushions to support the back and pelvis.
• Having another adult place the baby in your arms if getting up is painful.

emotional impact and support

A postpartum infection often disrupts what parents had imagined:

• Longer hospital stay than expected.
• Monitoring, IV lines, repeated blood tests.
• Worries about the baby catching something.
• Fear that the body is “failing”.

These feelings are understandable. Fatigue, hormonal changes and pain already make this period delicate, adding fever and treatment can accentuate anxiety.

Warning signs of significant psychological distress include:

• Persistent sadness or loss of interest.
• Strong guilt, even when professionals explain that nothing “wrong” was done.
• Intrusive worries about death or severe illness.
• Panic attacks or avoidance of baby care.

Talking about these emotions with caregivers or mental health professionals can greatly ease the load and help restore confidence in your own capacities as a parent.

organising daily life with a newborn

During recovery from puerperal endometritis, it may help to:

• Focus on feeding and cuddling as priorities.
• Delegate:
• Household chores.
• Cooking.
• Shopping.
• Administrative tasks.
• Reduce unnecessary demands:
• Limit visits if they leave you exhausted.
• Choose shorter, calmer interactions.

Partners, family or friends can also:

• Do night changes so you stand up less often.
• Prepare healthy snacks and drinks within arm’s reach.
• Take turns doing skin‑to‑skin with the baby, supporting bonding while you rest.

Listening to your body and accepting that recovery takes time is not a weakness, it is a way to care for both you and your child.

recovery, follow‑up and self‑care

Many women experience a clear improvement 2–3 days after the start of effective treatment:

• Fever fades.
• Appetite returns.
• The feeling of “being ill” diminishes.

Pelvic pain may take longer to resolve completely, especially after cesarean or complicated labour.

gradual return to activity

A possible rhythm:

• First days:
• Rest.
• Short walks to the bathroom or corridor.
• Gentle stretching.
• Following weeks:
• Light walks at home or outdoors.
• Avoid heavy lifting and intense exercise.
• Resuming sexual intercourse:
• Often after 4–6 weeks.
• Once bleeding has nearly stopped.
• When pain has disappeared and both partners feel ready.

Paracetamol and ibuprofen, compatible with breastfeeding, remain the base of pain relief. Stronger analgesics can be used for a short time if necessary, with medical supervision.

Talking about contraception during postpartum visits is important: ovulation can return before the first period, especially if breastfeeding is not exclusive. Several methods are compatible with lactation, and the choice can be adapted to your preferences and medical profile.

follow‑up visits and questions to ask

During follow‑up with your midwife, GP or obstetrician, you may want to discuss:

• Persistence or return of fever, even low‑grade.
• Residual pelvic pain.
• Pattern and smell of lochia.
• Healing of scars.
• Possible consequences for future pregnancies.
• Emotional state, sleep, appetite, relationship to your body.

You can also talk about the way puerperal endometritis was handled: what made you feel secure, what worried you, and what information would help you feel more in control next time.

à retenir

• Puerperal endometritis is a postpartum infection of the uterine lining that usually appears in the first 6 weeks after birth, often around days 3–5, and responds well to prompt broad‑spectrum antibiotic treatment.
• The risk is higher after cesarean section, especially when labour has already started or membranes have been ruptured for a long time, which is why antibiotic prophylaxis and careful intrapartum care are widely used.
• Warning signs include: persistent or high fever, pelvic or uterine pain that worsens instead of improving, and lochia that become foul‑smelling or change abruptly in colour or quantity. Any of these signs deserve medical advice.
• Diagnosis rests primarily on clinical examination, supported by blood tests, urine tests and sometimes pelvic ultrasound or advanced imaging to look for retained products, haematoma or abscess.
• Most mothers improve within 24–72 hours of starting appropriate treatment and can continue breastfeeding, with limited impact on long‑term fertility when management is timely.
• In rare cases, puerperal endometritis can lead to complications such as pelvic abscess, peritonitis or septic pelvic thrombophlebitis, which require hospital care, drainage procedures or anticoagulation.
• Paying attention to postpartum signals, asking questions and seeking help early are powerful tools to protect both maternal health and newborn wellbeing.

Pour un accompagnement personnalisé, des rappels utiles et des questionnaires de santé gratuits pour vos enfants, vous pouvez télécharger l’application Heloa. Elle offre un soutien pratique au quotidien, en complément des échanges avec vos professionnels de santé.

Questions Parents Ask

Can puerperal endometritis come back in a future pregnancy?

A history of puerperal endometritis does not automatically mean it will happen again. Many parents vivent une grossesse suivante sans aucune infection. The risk can be a little higher if the same circumstances repeat (emergency cesarean after a long labour, prolonged rupture of membranes, untreated genital infection, severe anaemia…).

During a next pregnancy, you can:

• Mention your previous endometritis early to your midwife or obstetrician.
• Discuter des facteurs qui avaient joué un rôle (durée du travail, césarienne en urgence, etc.).
• Vérifier et traiter en amont les infections urinaires, la vaginose bactérienne ou un diabète déséquilibré.

Rassurez‑vous : avec un suivi adapté et des mesures de prévention (comme les antibiotiques préventifs en cas de césarienne), la grande majorité des parents n’auront pas de récidive.

Is there anything I can do at home to lower my risk of postpartum uterine infection?

Vous ne pouvez pas tout contrôler autour de l’accouchement, et cela ne dépend jamais uniquement de vous. En revanche, quelques habitudes peuvent soutenir votre corps et faciliter la détection précoce d’une infection :

• Hygiène douce : se laver les mains avant de changer les protections, garder la zone vulvaire propre avec de l’eau et un savon doux, sans douche vaginale interne ni produits agressifs.
• Protections périodiques : privilégier les serviettes hygiéniques plutôt que les tampons ou la coupe menstruelle tant que les lochies sont présentes.
• Repos et alimentation : essayer de dormir dès que possible, boire suffisamment, manger des aliments riches en fer et en protéines pour aider la cicatrisation.
• Observation bienveillante : prêter attention à la fièvre, à l’odeur des lochies, à la douleur pelvienne, sans se surveiller de façon anxieuse. Si quelque chose vous inquiète, un simple appel à une sage‑femme, un·e médecin ou la maternité peut vraiment aider.

L’idée n’est pas d’être “parfaitement prudente”, mais plutôt de connaître les signaux qui méritent un avis médical, tout en vous laissant le droit de vous reposer et de profiter de votre bébé.

How will I know when I’m fully recovered, and can I go back to normal activities?

Après une endométrite du post‑partum, beaucoup de parents sentent une amélioration nette en quelques jours, mais le retour à la forme habituelle prend souvent plusieurs semaines. Vous pouvez considérer que la guérison avance bien lorsque :

• La fièvre a disparu et ne revient pas.
• Les douleurs pelviennes diminuent progressivement.
• Les lochies deviennent plus claires et moins abondantes.
• Vous retrouvez peu à peu de l’énergie pour marcher, vous doucher, prendre soin de votre bébé.

Pour les activités :

• Déplacements et tâches légères : souvent possibles dès que la fièvre a cessé et que les douleurs sont modérées.
• Porter des charges lourdes, sport, ménage intensif : mieux vaut reprendre très progressivement, surtout après césarienne.
• Vie sexuelle : beaucoup de équipes recommandent d’attendre environ 4 à 6 semaines, lorsque les saignements se sont presque arrêtés et que vous vous sentez prête physiquement et émotionnellement.

Vous pouvez en parler lors du rendez‑vous postnatal : expliquer ce que vous ressentez, poser vos questions sur le sport, la sexualité, le travail ou un futur projet de grossesse. Il est important que vous vous sentiez accompagnée pour adapter le rythme de reprise à votre corps et à votre situation.

Further reading :

• Postpartum Endometritis – Gynecology and Obstetrics – MSD Manuals
• Endometritis – StatPearls – NCBI Bookshelf – NIH