Intravenous laser blood irradiation in the prevention of infectious and inflammatory complications in puerperas after abdominal delivery

Objective. To evaluate the clinical efficiency of intravenous laser blood irradiation (ILBI) in the prevention of infectious and IICs in puerperas after cesarean section. Subject and methods. A study group consisted of 126 puerperas after cesarean section. All the puerperas received antibiotic prophylaxis with amoxiclav 1.2 g intravenously 15 minutes before skin incision. After surgery, the puerperas were divided into 2 groups: 1) 65 puerperas who, beginning from postoperative day 1, underwent daily ILBI using a Solaris device (Russia) with helium-neon laser at a wavelength of 0.63 nm during 15 minutes for 5 days (a study group); 2) 61 puerperas who had antibiotic prophylaxis only (a comparison group). From the first operative days, all the puerperas daily underwent thermometry, assessment of pain intensity according to a visual analogue scale, the breast, and fundal height, ultrasonographic examination of the postpartum uterus, and determination of peripheral blood parameters and C-reactive protein (CRP) levels. The pattern of postoperative complications and the number of hospital bed days were analyzed. Results. The mean age of the puerperas in the study and comparison groups were 31.2±5.4 and 30.5±5.1 years, respectively (р?0.05). All the women had a poor obstetric history and a complicated current pregnancy. The risk factors of postoperative IICs were identified. Prophylactic postoperative ILBI promptly normalized the total count of white blood cells, lowered erythrocyte sedimentation rate, increased lymphocyte and hemoglobin levels, and significantly decreased SRP; postoperative pains were more rapidly relieved and body temperature became normal. Lactation was noted on days 3.8±0.8 and 4.2±0.4 in Groups 1 and 2, respectively. Lactostasis was observed in 5 (8.2%) puerperas in the comparison group and in none in the study group. The babies of the study group puerperas were on breastfeeding in 83.1% of cases and on mixed feeding in 16.9%. In the comparison group, 62.3% of the babies were breastfed, 22.9% and 14.7% were on mixed and formula feeding, respectively. In the postpartum period, Groups 1 and 2 showed physiological puerperium in 95.4 and 86.9% of cases, respectively. Both groups had complications in 4.6 and 13.1%, respectively; moreover, complications, such as wound infection and endometritis, were absent in the study group, which provides an explanation for the larger number of bed days in the comparison group. Group 1 spent fewer (5.8±0.74) postoperative bed days, Group 2 did 6.5±1.3 days. ILBI caused no complications in the puerperas. Conclusion. ILBI was shown to be highly effective and safe in puerperas at risk for postoperative IICs. The absence of adverse reactions caused by ILBI and its safety can recommend the technique to use as part of preventive measures to prevent IICs after cesarean section.

cesarean section, infectious and inflammatory complications, prevention, intravascular laser blood irradiation, safety and efficiency