Which of the following is a risk factor for endometritis?

• A. Vaginal delivery
• B. Cesarean section
• C. Long-term oral contraceptive use
• D. Regular exercise

Answer: (B)

Endometritis is a postpartum uterine infection that most strongly correlates with procedures that breach the uterine barrier and introduce vaginal flora into the uterine cavity. A cesarean section does exactly that: it involves opening the uterus and can expose the endometrium to bacteria from the vagina, especially in the setting of labor, ruptured membranes, or multiple vag exams. This makes cesarean delivery a clear risk factor for developing endometritis. In contrast, vaginal delivery has a lower risk, and long-term oral contraceptive use or regular exercise do not increase the risk for endometritis.