PREVENTION OF POSTPARTUM ENDOMETRITIS IN PUERPERAS AT RISK FOR INFECTIONS

Objective. To improve the results of treatment in puerperas, by assessing the risk factors of infection, verifying its pathogen, and using high-amplitude ultrasound. Material and methods. At Stage 1, labors (n=180) complicated by postpartum endometritis were retrospectively analyzed to identify the major risk factors of postpartum pyoinflammatory complications. At Stage 2, a prospective study (n=121) was conducted to evaluate the impact of the length of a dry labor period on the degree of systemic inflammation and the levels of TNF-a, lactoferrin, lysozyme, and SIgA were determined in the amniotic fluid and serum of the examinees. At Stage 3, the eff iciency of the novel combination method to prevent postpartum endometriosis, which encompassed antibiotic prophylaxis and high-amplitude ultrasound physiotherapy (n=65), was evaluated. Results. Mixed infections were found to prevail in the development of pyoinflammatory diseases with the leading role being played by the gram-positive bacterial microflora. In the dry labor period of above 24 hours, the levels of lactoferrin in the serum and amniotic fluid increased by 3.8 and 2.3 times and those TNF-a did by 2.2 and 9.8 times, respectively. Conclusion. The combination treatment involving antibiotic prophylaxis and high-amplitude ultrasound therapy was shown to have some advantage over conventional drug treatment.

postpartum endometritis, risk factors, prevention, dynamically allocated high-amplitude ultrasound