CURRENT SURGICAL TREATMENT IN PUERPERAS WITH UTERINE SCAR DEHISCENCE FOLLOWING CESAREAN DELIVERY AND WITH OBSTETRIC PERITONITIS

Objective. To improve the outcomes of treatment for obstetric peritonitis following cesarean delivery, by performing organ-saving treatment andpathogenetically warranted intensive therapy in the postpartum period. Subjects and methods. Twenty-two clinical cases with peritonitis underwent organ-saving surgery with metroplasty and application of secondary sutures to the uterus. Results. The authors discuss management tactics for puerperas with obstetric peritonitis developing in the presence of inconsistent uterine sutures and current criteria for the examination and treatment of these patients. They show the needfor using procalcitonin, leukocyte index of intoxication, and integral scales of organ dysfunctions in the algorithm of examination of puerperas with obstetric peritonitis. Conclusion. The current approaches to surgical treatment and starting antibacterial therapy with ultrabroad-spectrum antibiotics in combination with early intensive therapy in an intensive care unit make it possible to avoid removal of the uterus as a primary focus.

puerperas, obstetric peritonitis, inconsistence of uterine sutures, uterine scar dehiscence, sepsis, systemic inflammatory response syndrome, antibacterial therapy, procalcitonin