Organ-sparing surgery for postpartum endometritis after cesarean section


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Abstract

Objective: To present the experience of treating women who have given birth with postpartum endometritis and cesarean scar defect using a comprehensive approach. Materials and methods: This was a retrospective study of 23 case histories of patients who have just given birth. A comprehensive approach was used in the treatment of the patients which included relaparotomy, a complete excision of necrotic scar tissue, secondary sutures followed by antibacterial therapy in combination with intrauterine injection of VNIITU-1PVP molded carbon sorbent. Results: The comprehensive approach to the treatment of patients with postpartum endometritis has been implemented since 2016. Its use has reduced the number of hysterectomies in comparison with the period 2009- 2015 (OR 2.568; 95% CI: 1.19-5.5). Endometritis was diagnosed in the women on day 9.79 (6.86). All patients had an increase in the number of white blood cells to 25.1*109/L, the level of C-reactive protein to 122 mg/L; 78.3% of the patients had a change in the leukocyte formula to 25% of rod-shaped neutrophils. Such bacteria as Enterococcus faecalis, Staphylococcus epidermidis and Enterococcus faecium prevailed in the microflora. There was a statistically signif icant decrease in white blood cells, rod-shaped neutrophils, and C-reactive protein (p<0.0001) by the 5th day of administering the complex therapy. Conclusion: The use of the comprehensive approach made it possible to reduce the percentage of hysterectomies twice and contributed to the formation of a complete scar.

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About the authors

Sergej V. Barinov

Omsk State Medical University, Ministry of Health of Russia

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

Oksana V. Lazareva

Omsk State Medical University, Ministry of Health of Russia

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

Irina V. Medyannikova

Omsk State Medical University, Ministry of Health of Russia

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

Yuliya I. Tirskaya

Omsk State Medical University, Ministry of Health of Russia

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

Tatyana V. Kadtsyna

Omsk State Medical University, Ministry of Health of Russia

PhD, Associate Professor of the Department of Obstetrics and Gynecology No. 2

Natalia N. Leont’eva

Center of New Chemical Technologies, Boreskov Institute of Catalysis SB RAS

Email: science@ihcp.ru
PhD (Chem.), Deputy Director for Science

Lyudmila L. Shkabarnya

Omsk State Medical University, Ministry of Health of Russia; Perinatal Center, Regional Clinical Hospital, Omsk

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

Yurij I. Chulovsky

Omsk State Medical University, Ministry of Health of Russia

PhD, Associate Professor of the Department of Obstetrics and Gynecology No. 2

Maxim N. Gritsyuk

Perinatal Center, Regional Clinical Hospital, Omsk

Email: balezl50284@mail.ru
Gynecologist of the Department of Gynecology

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