Which condition increases risk for postpartum endometritis?

• A. Gestational DM
• B. Placenta previa
• C. C-section
• D. PPROM/PROM

Answer: (D)

Postpartum endometritis is an infection of the uterine lining after delivery that usually results from vaginal bacteria ascending into the uterus when the protective membrane barrier is disrupted. When membranes rupture, bacteria from the vagina have an easier path to the uterine cavity, and the risk grows the longer the membranes are ruptured. Premature rupture of membranes or rupture of membranes at term (PROM/PPROM) creates prolonged exposure and a higher chance for ascending infection, making this scenario the strongest predictor of postpartum endometritis. While cesarean delivery also increases risk due to surgical factors, the direct mechanism linking PROM/PPROM to endometritis is the breach of the barrier that allows infection to ascend into the uterus.