ABSTRACT
In the course of performing a cesarean section, the basalis layer of the endometrium is iatrogenically disrupted. The devitalized tissue (resulting from clamping, loss of its vascular supply, and coagulation) coupled with microhematoma formation along the line of tissue reapproximation not only creates conditions favorable for anaerobic bacterial replication but also circumvents the principal anatomical barrier to anaerobic infection. While intra-amniotic fluid infection caused by selected class I aerobes tends to select for chorioamnionitis, the presence of class II anaerobes, i.e., Peptostreptococci and Bacteroidaceae, is apparently a partial catalytic factor in the induction of endomyometritis in the absence of virulent class I aerobes.
