Abstract

Postpartum purulent-septic complications (PPSC) and their problems are most urgent for modern obstetrics due to their significant frequency. Maternal sepsis is one of the leading causes of maternal mortality around the world, accounting for about one-tenth of the global number of maternal deaths. Understanding the risk factors for the development of septic complications of puerperium is important for preventive strategies. Aim. To study the possibility of forming high-risk groups on the basis of analysis of anamnestic data and the course of puerperium in women with PPSC as part of the preventive measures for the development of such complications. Materials and methods. The first stage of the study involves a retrospective analysis for the allocation of risk factors for the development of PPSC in women, who underwent inpatient treatment for this pathology - main group (n=108); сontrol group (n=35) – parous with uncomplicated flow of the postpartum period. Prospective research enrolled 65 pregnant women with extragenital pathology and/or complicated pregnancy (group 1); 30 pregnant women without severe concomitant somatic pathology with physiological course of pregnancy (group 2). The following were taken into account: age, obstetrical and gynecological history, extragenital pathology, laboratory diagnostic data. Differences in mean values were considered significant with a probability level of at least 95 % (p<0.05). Results. To the risk factors for the development of PPSC, we classified as follows: gynecological diseases in history: menstrual dysfunction, chronic inflammatory diseases of the genital organs, bacterial vaginosis; complications of pregnancy and labor: preeclampsia, preterm labor, premature rupture of membranes, long anhydrous span, chorioamnionitis, weakness of labor, genital tract ruptures, placental attachment pathology, operative vaginal birth, bleeding; concomitant extragenital pathology: diabetes, obesity, diseases of the urinary system, diseases of the cardiovascular system, respiratory diseases, varicose disease, anemia. Conclusions. The connection between the presence of concomitant somatic pathology, the complicated course of pregnancy and labor and the subsequent development of septic complications in the postpartum period have been established. Prediction of the risk of their occurrence at the stage of pregraviditic preparation, with various complications of pregnancy and childbirth, especially in women with extragenital pathology, differential prevention will reduce the frequency of PPSC.

Highlights

  • Bacterial infections during childbirth and in puerperium are among the leading causes of maternal mortality worldwide, accounting for about 10.7 % of all maternal deaths [1, 2]

  • Prediction of the risk of their occurrence at the stage of pregraviditic preparation, with various complications of pregnancy and childbirth, especially in women with extragenital pathology, differential prevention will reduce the frequency of Postpartum purulent-septic complications (PPSC)

  • It was found that in women with PPSC this pregnancy ended up preterm labor, that was significantly higher (12.96 %) in comparison to the control group (p

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Summary

Introduction

Bacterial infections during childbirth and in puerperium are among the leading causes of maternal mortality worldwide, accounting for about 10.7 % of all maternal deaths [1, 2]. Most of the estimated 75000 maternal deaths worldwide occur every year as a result of infections are recorded in low-income countries, while in high-income countries 0.1–0.6 per 1000 births [3, 4]. Patients in the treatment group received antibacterial therapy for 7 days + treatment with standard dosage of medicinal product Canephron N for 3 months. By 30 day in GP patients in the treatment group bacteriuria was detected in 2/30 (6.67 %) patients, and in the control group – in 5/30 (16.7 %) patients (p 1: 2

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