СОВРЕМЕННЫЕ ПРЕДСТАВЛЕНИЯ О ПОСЛЕРОДОВОМ ЭНДОМЕТРИТЕ (ОБЗОР ЛИТЕРАТУРЫ)

Abstract

The review is based on the databases https://cyberleninka.ru/, PubMed, MedArt, and CNMB. Postpartum endometritis is the leading infectious and inflammatory disease of the postpartum period and one of the stable leading causes of maternal mortality. In Russia, the incidence of postpartum endometritis in the population is 3-8%, in pathological deliveries it is 10-20%, and in women with a high infection risk it is 13.3-54.3%. Infection occurs predominantly by the ascending route, as a rule, with active participation in associations of opportunistic pathogenic flora. The leading position among the risk factors of postpartum endometritis is taken by surgical delivery and, primarily, by cesarean section. Immune disorders play one of the key roles in the pathogenesis of this disease according to modern researchers. In case of insufficient effectiveness of empirical antibacterial therapy, the choice of antibacterial drugs must be made on the basis of blood cultures. The second local component of treatment of patients with postpartum endometritis is the evacuation of uterine cavity contents. Careful emptying is one of the most important criteria for choosing the method of evacuation. An immunomodulatory component should be included in the treatment to increase its effectiveness. Thus, postpartum endometritis is a serious obstetric problem, in the treatment of which gentle evacuation of the uterine cavity contents in combination with local use of immunomodulatory drugs is promising.