What is the most important risk factor for the development of postpartum endometritis?

The most important risk factor for the development of postpartum endometritis is cesarean section. This surgical procedure exposes the uterus to the external environment, increasing the risk of infection compared to vaginal delivery. The uterus, which is normally a sterile environment, can become contaminated with bacteria during surgery and due to the extended recovery period and potential complications that can arise, the likelihood of endometritis significantly increases.

Moreover, cesarean deliveries often involve a longer hospital stay and more invasive interventions, which are additional factors that contribute to the risk of infection. This risk is particularly pronounced if the cesarean is performed after the onset of labor, as this can introduce bacteria from the vagina into the uterine cavity.

While other factors, such as maternal age, multiple internal examinations, and preterm labor, may increase the risk of various complications during or after delivery, cesarean section stands out as the most significant factor specifically associated with postpartum endometritis. Understanding this connection is crucial for anticipating and managing potential infections post-delivery.