The early diagnostics of obstetric sepsis

Аннотация

Objective: the research aimed at the working out the syndrome diagnostics of the progress of pregnancy endotoxemia into sepsis.

Полный текст

Methods: there were examined 86 women, presumably having sepsis during delivery and in the first hours and days of postnatal stage. There were applied clinical, immunologic, hemostasiological, dopplerometrical, ultrasonic, bacteriology, biochemical, electrocardiografical methods of investigation.

Results: there were identified different variations of the transition to the septic state, characterized by the combination of laboratory, ultrasonic and bacteriology criteria. The most frequent and predictably dangerous diseases were the following variants: the 1 variant - pancytopenia and anemia, extension of all coagulation tests with an appearance of products of fibrin degradation, the increase in urea, creatinine, direct bilirubin, transaminase levels, the increase in R-protein, homoreactants level, IgG decrease; the 2 variant - hyper leukocytosis with a regeneratory deviation of neutrophils till leukomoides reaction, anemia with a great number of reticulocytes, the increase in nonconjugated blood bilirubin, a tendency to hypercoagulation and hyperagrigation of thrombocytes, the high level of IgM and the intensive rise of vagina pathogen flora.

Conclusions: individual treatment foresees the immunity stimulating therapy in the first variants, the urgent detoxemia treatment is needed in the second variant. The ultrasonic signs identification of a shock uterus with manifested miometritis in absence of full clinical symptomatic with no effect of detoxemia treatment in 12 - 24 hours needs drastic operative treatment.