Womb infection (Intrauterine infection) - Symptoms, Causes, Treatment & Prevention

📅 Updated: May 2026 ⏱️ 7 min read ✅ Medically reviewed
```html Womb Infection (Intrauterine Infection) – Complete Medical Guide

Overview

An intrauterine infection, commonly referred to as a “womb infection,” is an infection that occurs within the uterus (the uterine cavity) during pregnancy. It can affect the placenta, amniotic fluid, fetal membranes (chorioamnion), or the fetus itself. While many pregnant women experience mild vaginal infections, intrauterine infections are far less common but carry a higher risk for maternal and fetal complications.

Who it affects: The condition can occur at any stage of pregnancy but is most frequently diagnosed in the second or third trimester. Women with certain medical histories or lifestyle factors are at higher risk.

Prevalence: In high‑income countries, intrauterine infection is identified in roughly 0.5–2% of all pregnancies. In low‑ and middle‑income settings, the rate can be as high as 5–10% due to limited prenatal care and higher incidence of sexually transmitted infections (STIs) 1.

Symptoms

Symptoms vary depending on which structure is infected and the gestational age. Below is a comprehensive list with brief explanations.

Maternal Symptoms

  • Fever (≥38°C/100.4°F) – often the first sign; may be low‑grade or high‑grade.
  • Uterine tenderness – pain on palpation of the abdomen or when the uterus contracts.
  • Abdominal or pelvic pain – cramping that may mimic labor.
  • Vaginal discharge – increased amount, change in color (yellow, green, gray) or foul odor.
  • Chills or rigors – shaking chills accompanying fever.
  • Rapid heart rate (tachycardia) – maternal heart rate >100 bpm.
  • Increased urinary frequency or burning – may suggest a urinary tract infection that has ascended.
  • Flu‑like symptoms – body aches, fatigue, headache.

Fetal/Neonatal Signs

  • Fetal tachycardia – heart rate >160 bpm on monitoring.
  • Fetal bradycardia – heart rate <110 bpm, indicating distress.
  • Decreased fetal movement – “quiet” baby felt by the mother.
  • Preterm labor – regular contractions leading to early delivery.
  • Low amniotic fluid (oligohydramnios) – noted on ultrasound.
  • Neonatal sepsis – after birth, baby may develop fever, lethargy, poor feeding.

Causes and Risk Factors

Intrauterine infection is usually polymicrobial, involving bacteria that ascend from the vagina or are introduced via the bloodstream.

Common Causative Organisms

  • Group B Streptococcus (GBS) – leading cause of early‑onset neonatal sepsis.
  • Ureaplasma urealyticum & Mycoplasma hominis – frequently isolated from chorioamnionitis.
  • Escherichia coli and other Gram‑negative rods.
  • Anaerobic bacteria – Bacteroides, Prevotella.
  • Viral infections – Cytomegalovirus, herpes simplex virus (HSV) can cause intrauterine inflammation, though bacteria are more common.

Risk Factors

  • Prolonged rupture of membranes (>18 hours) 2.
  • Invasive procedures: amniocentesis, chorionic villus sampling, intrauterine device (IUD) placement.
  • Multiple vaginal examinations during labor.
  • Pre‑existing genital tract infections (bacterial vaginosis, trichomoniasis, gonorrhea, chlamydia).
  • Preterm premature rupture of membranes (PPROM).
  • Maternal diabetes, obesity, or immunosuppression.
  • History of prior intrauterine infection or preterm birth.
  • Smoking and illicit drug use.

Diagnosis

Timely diagnosis is essential to minimize maternal and fetal harm. It typically involves a combination of clinical assessment and laboratory tests.

Clinical Evaluation

  • Maternal vital signs: fever, heart rate, blood pressure.
  • Physical exam: uterine tenderness, pelvic exam for discharge.
  • Fetal monitoring: non‑stress test (NST) or continuous cardiotocography (CTG) for heart‑rate patterns.

Laboratory and Imaging Tests

  • Complete blood count (CBC) – leukocytosis (>15,000 cells/µL) suggests infection.
  • C‑reactive protein (CRP) and procalcitonin – inflammatory markers that rise early.
  • Maternal blood cultures – identify bloodstream infection.
  • Vaginal and cervical cultures – Gram stain and PCR for GBS, Ureaplasma, Mycoplasma.
  • Amniocentesis (if safe) – analysis of amniotic fluid for white‑blood‑cell count, glucose, Gram stain, and culture.
  • Ultrasound – assesses fetal growth, amniotic fluid volume, and placental appearance.
  • Placental pathology – after delivery, histologic examination can confirm chorioamnionitis.

Diagnostic Criteria (CDC)

The Centers for Disease Control and Prevention define clinical chorioamnionitis (a common manifestation of intrauterine infection) when a pregnant woman has a fever ≥38°C plus at least one of the following: maternal tachycardia, fetal tachycardia, uterine tenderness, foul‑smelling amniotic fluid, or purulent cervical discharge 3.

Treatment Options

Management is directed at eradicating the infection, preventing maternal complications, and protecting the fetus.

Antibiotic Therapy

  • Empiric broad‑spectrum IV antibiotics are started promptly, usually:
    • ampicillin 2 g IV every 6 h (covers GBS and Listeria).
    • gentamicin 1.5 mg/kg IV every 8 h (Gram‑negative coverage).
    • or clindamycin 900 mg IV every 8 h if anaerobes are suspected.
  • Once culture results return, therapy is narrowed (de‑escalation) to target the identified organism.
  • Typical course: 48 – 72 hours before delivery, then oral antibiotics (e.g., amoxicillin‑clavulanate) for 5–7 days postpartum.

Delivery Management

  • If the infection is severe or the pregnancy is beyond 34 weeks, prompt delivery** is recommended** to protect the baby.
  • For pre‑term gestations (<34 weeks) with controlled infection, clinicians may attempt to prolong pregnancy with steroids for fetal lung maturity while on antibiotics.

Adjunctive Therapies

  • Corticosteroids (betamethasone 12 mg IM, two doses 24 h apart) – administered if delivery before 34 weeks is anticipated.
  • Tocolytics (e.g., nifedipine) – may be used briefly to delay labor while steroids take effect.

Supportive Care

  • IV fluids, antipyretics (acetaminophen), and oxygen as needed.
  • Monitoring for sepsis: lactate levels, urine output, mental status.

Lifestyle and Home Care (post‑discharge)

  • Complete the full antibiotic course.
  • Maintain good perineal hygiene – wipe front‑to‑back, change pads frequently.
  • Limit sexual activity until cleared by a provider.
  • Stay hydrated and rest adequately.

Living with Womb Infection (Intrauterine Infection)

Even after successful treatment, many women wonder how to manage daily life while protecting future pregnancies.

Self‑Monitoring

  • Track temperature daily for the first week post‑treatment.
  • Note any new or worsening pelvic pain, foul discharge, or vaginal bleeding.
  • Perform fetal movement counts after 28 weeks (10 movements in 2 hours).

Nutrition & Hydration

  • Eat a balanced diet rich in protein, iron, calcium, and folic acid to support immune recovery.
  • Drink at least 2–3 L of water daily unless fluid restriction is advised.

Physical Activity

  • Mild‑to‑moderate activity (walking, prenatal yoga) is safe once fever resolves.
  • Avoid heavy lifting or strenuous exercise for at least 2 weeks.

Emotional Well‑Being

  • Experiencing a womb infection can be stressful; consider counseling or a support group.
  • Mind‑body techniques such as deep breathing, meditation, or guided imagery can reduce anxiety.

Future Pregnancy Planning

  • Wait at least 6 months after completing antibiotics before trying to conceive again, allowing the uterine environment to fully recover.
  • Discuss pre‑conception screening for STIs and GBS with your OB‑GYN.

Prevention

Many risk factors are modifiable. Below are evidence‑based strategies to lower the chance of an intrauterine infection.

  • Screen & treat genital infections early – routine prenatal testing for bacterial vaginosis, chlamydia, gonorrhea, and GBS (at 35‑37 weeks) is recommended by the CDC.
  • Limit vaginal examinations during labor to those that are clinically necessary.
  • Promptly treat premature rupture of membranes – antibiotics are given prophylactically when membranes rupture before 34 weeks.
  • Maintain good personal hygiene – avoid douching and use mild, fragrance‑free cleansers.
  • Vaccinations – influenza and Tdap vaccines protect pregnant women from infections that could ascend to the uterus.
  • Control chronic conditions – keep diabetes and hypertension well‑managed.
  • Avoid smoking, alcohol, and illicit drugs – all increase infection susceptibility.

Complications

If left untreated or inadequately managed, intrauterine infection can lead to serious short‑ and long‑term outcomes.

Maternal Complications

  • Sepsis and septic shock.
  • Endometritis (post‑partum uterine infection).
  • Placental abruption.
  • Increased risk of future infertility due to scarring.

Fetal/Neonatal Complications

  • Preterm birth (leading cause of neonatal morbidity).
  • Low birth weight and neonatal intensive care unit (NICU) admission.
  • Neonatal sepsis and meningitis.
  • Developmental delay or cerebral palsy due to intra‑uterine inflammation.
  • Stillbirth (particularly with severe or prolonged infection).

When to Seek Emergency Care

Call 911 or go to the nearest emergency department immediately if you experience any of the following:
  • Fever ≥ 38.5 °C (101.3 °F) that does not improve with acetaminophen.
  • Severe abdominal or pelvic pain with rigidity (hard belly).
  • Rapid breathing (≥ 30 breaths per minute) or shortness of breath.
  • Sudden change in fetal movement – markedly decreased or absent.
  • Heavy vaginal bleeding (soaking a pad in < 30 minutes).
  • Persistent vomiting or inability to keep fluids down.
  • Signs of septic shock: low blood pressure, confusion, chills with a high fever.

Prompt treatment can be lifesaving for both mother and baby.

**References**

  1. World Health Organization. Infection in pregnancy: prevention and management. WHO, 2022.
  2. American College of Obstetricians and Gynecologists (ACOG). Management of Preterm Premature Rupture of Membranes. Practice Bulletin No. 217, 2020.
  3. Centers for Disease Control and Prevention. Chorioamnionitis (Intrauterine Infection), updated 2023.
  4. Mayo Clinic. Chorioamnionitis symptoms and causes, accessed May 2024.
  5. Cleveland Clinic. Intrauterine Infection (Chorioamnionitis), 2024.
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⚠️ Medical Disclaimer

Important: The information provided on this page is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

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