Clinical Characteristics and Treatment Results of Women with Various Forms of Infectious and Inflammatory Diseases of the Postpartum Period
O. V. Lazareva,
S. V. Barinov,
E. M. Shifman,
L. L. Sckabarnya,
Yu. I. Tirskaya,
T. V. Kadtsyna,
Ju. I. Chulovskij,
A. E. Pukha https://doi.org/10.52420/umj.23.6.18
EDN: CZALAA
Abstract
Introduction. The issues of managing postpartum women with infectious and inflammatory diseases (IID) are extremely relevant in modern conditions.
The aim of the study is to present the clinical characteristics and features of treatment of women in labor with various forms of postpartum pulmonary dysfunction.
Materials and methods. A retrospective examination of 181 postpartum mothers with IID was carried out, who were divided into 3 groups: A (n = 122) — patients with uncomplicated endometritis; B (n = 43) — with complicated forms (suture failure, metrothrombophlebitis); C (n = 16) — with severe septic complications (parametritis, obstetric peritonitis).
Results. In groups B and C, chorioamnionitis was statistically significantly more often diagnosed during labor compared to uncomplicated endometritis (pA–B = 0.002, pA–C < 0.001). In the integrated the number of points on the NEWS2 scale was statistically significantly higher in group B (p = 0.050) and group C (p = 0.007) compared to group A. In 25.42 % of the subjects, there was a discrepancy between the prescribed empirical antibacterial therapy and the pathogen isolated. In group B, organ-preserving surgery was performed in 55.81 % of the mothers on day 6.5 [4.8; 11.0], and hysterectomy was performed on day 9.0 [6.0; 12.0] after delivery.
Conclusion. Chorioamnionitis during childbirth, a score on the NEWS2 scale of 2 or more points suggests the development of complicated forms of postpartum endometritis. When treating, preference should be given to antibiotics of the aminopenicillin group, amoxicillin and beta-lactamase inhibitors, carbapenems and a timely decision should be made on repeated surgical intervention, allowing for organ-preserving surgery.
About the Authors
O. V. Lazareva
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Oksana V. Lazareva — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
S. V. Barinov
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Sergey V. Barinov — Doctor of Sciences (Medicine), Professor, Head of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
E. M. Shifman
Moscow Regional Research and Clinical Institute; N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Efim M. Shifman — Doctor of Sciences (Medicine), Professor, Professor of the Department of Anesthesiology and Intensive Care, Moscow Regional Research and Clinical Institute; Professor of the Department of Anesthesiology and Intensive Care, N. I. Pirogov Russian National Research Medical University
Moscow
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
L. L. Sckabarnya
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Lyudmila L. Sckabarnya — Head of the Department of Gynecology
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
Yu. I. Tirskaya
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yulia I. Tirskaya — Doctor of Sciences (Medicine), Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
T. V. Kadtsyna
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Tatyana V. Kadtsyna — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
Ju. I. Chulovskij
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Jurij I. Chulovskij — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
A. E. Pukha
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Anastasiya E. Pukha — Clinical Resident of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflicts of interest.
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Lazareva OV, Barinov SV, Shifman EM, Sckabarnya LL, Tirskaya YI, Kadtsyna TV, Chulovskij JI, Pukha AE. Clinical Characteristics and Treatment Results of Women with Various Forms of Infectious and Inflammatory Diseases of the Postpartum Period. Ural Medical Journal. 2024;23(6):18–34. (In Russ.) https://doi.org/10.52420/umj.23.6.18. EDN: CZALAA
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