Which organism is a recognized risk factor for postpartum endometritis?

• A. Group B Streptococcus colonization
• B. Escherichia coli urinary tract infection
• C. Candida albicans vaginitis
• D. Chlamydia trachomatis infection

Answer: (A)

Postpartum endometritis occurs when bacteria from the genital tract ascend into the uterus after delivery, especially in the setting of labor, ruptured membranes, or cesarean delivery. Group B Streptococcus colonization is a recognized risk factor because it commonly inhabits the vaginal and cervical areas and can seed the uterine lining during delivery, increasing the chance of endometritis. The other organisms listed are less directly linked to postpartum uterine infection: E. coli causing a urinary tract infection isn’t the same as a uterine infection; Candida albicans vaginitis is a fungal vaginal infection with little tendency to cause endometritis; and Chlamydia trachomatis is more associated with pelvic inflammatory disease rather than postpartum uterine infection.