Clinical and diagnostic criteria for postpartum endometritis according to delivery mode


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Abstract

Aim. To investigate risk factors, clinical and diagnostic criteria for the development of postpartum endometritis according to delivery mode. Materials and methods. The present study retrospectively analyzed 97 cases of postpartum endometritis, including 55 (group A) and 42 (group B) patients who underwent cesarean and vaginal delivery, respectively. Results. The mean age of patients was 27.7 (5.7) years. In group A, 12/55 (21.8%) women had repeat emergency caesarean delivery and 74.5% (41/55) required an emergency caesarean section. In group A, patients were significantly more likely to have gynecological diseases (x2=3.562; p=0.056), preeclampsia (x2=0.743; p=0.003), leukocytosis (x2=3.762; p=0.052), stab neutrophils (х‘=6.1б9; p=0.013), anemia (x2=4.767; p=0.029), thrombocytosis (x2=11.526; p=0.000), hypoproteinemia (x2=6.047; p=0.014), hypercoagulability (x2=4.342; p=0.037). The symptoms of endometritis developed statistically significantly more often on days 2-4 after cesarean section (x2=7.590; p=0.006). Uterine subinvolution and hematometra were detected by ultrasound in 50/55 (90.9%) women in group A and in 41/42 (97.6%) in group B. Placenta accreta spectrum was observed in 3/55 (5.5%) and 4/42 (9.5%) cases in groups A and B, respectively. The main identified microflora in puerperal women included Staphilococcus epidermidis, Esherichia coli, and enterococci in 28/97(28.9%), 20/97(20.0%), and 25/97(25.8%) cases, respectively. Conclusion. Cesarean section is associated with more severe postpartum endometritis and septic complications than vaginal delivery.

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About the authors

Sergey V. Barinov

Omsk State Medical University, Ministry of Health of Russia

Email: barinov_omsk@mail.ru
Dr.Med.Sci., Professor, Head of the Department of Obstetrics and Gynecology №2

Oksana V. Lazareva

Omsk State Medical University, Ministry of Health of Russia

Email: lazow@mail.ru
Ph.D., Associate Professor, Department of Obstetrics and Gynecology №2

Lyudmila L. Shkabarnya

Perinatal Centre of Omsk Regional Clinical Hospital

Email: l_shka@mail.ru
Head of the Department of Gynecology

Vladimir E. Savculich

Perinatal Centre of Omsk Regional Clinical Hospital

Email: erutar_sava@mail.ru
Physician at the Department of Gynecology

Anastasia S. Sycheva

Omsk State Medical University, Ministry of Health of Russia

Email: defenceless123@mail.ru
Resident at the Department of Obstetrics and Gynecology №2

Yuliya I. Tirskaya

Omsk State Medical University, Ministry of Health of Russia

Email: yulia.tirskaya@yandex.ru
Dr.Med.Sci., Associate Professor, Department of Obstetrics and Gynecology №2

Yegor A. Khoroshkin

Omsk State Medical University, Ministry of Health of Russia

Email: drrussian@mail.ru
Medical Student

Tat’yana V. Kadtsyna

Omsk State Medical University, Ministry of Health of Russia

Email: tatianavlad@list.ru
Ph.D., Associate Professor, Department of Obstetrics and Gynecology №2

Irina V. Medyannikova

Omsk State Medical University, Ministry of Health of Russia

Email: mediren@gmail.com
Dr.Med.Sci., Associate Professor, Department of Obstetrics and Gynecology №2

Yurij I. Chulovsky

Omsk State Medical University, Ministry of Health of Russia

Email: akusheromsk@rambler.ru
Ph.D., Associate Professor, Department of Obstetrics and Gynecology №2

Galina B. Beznoshchenko

Omsk State Medical University, Ministry of Health of Russia

Email: akusheromsk@rambler.ru
Dr.Med.Sci., Professor, Department of Obstetrics and Gynecology №2

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