• Diagnosis and prediction of postpartum endometritis: a new look at the problem

Diagnosis and prediction of postpartum endometritis: a new look at the problem

PERINATOLOGIYA I PEDIATRIYA. 2017.1(69):59-64; doi 10.15574/PP.2017.69.59

Diagnosis and prediction of postpartum endometritis: a new look at the problem

Bulavenko O., Ostap'yuk L., Rud V., Voloshynovskyi A.
National Pirogov Memorial Medical University, Ukraine

Ivan Franko National University of Lviv, Ukraine

Purpose — to improve the diagnosis and prognosis of postpartum endometritis by applying the method of fluorescence spectroscopy.

Materials and methods. The study involved 120 women with postpartum endometritis and 38 women with uncomplicated postpartum period (control group). Fluorescence spectral characteristics of blood serum, including repeat testing in the course of treatment, were studied.

Results. It was shown that significant (p<0.05) prognostic factors of postpartum endometritis are the presence of inflammatory diseases of the lower genital tract, anomalies of labor activity and TORCH-infections. It was established that the decrease in fluorescence intensity and the presence of long-wavelength shift are reliable diagnostic markers of inflammatory diseases, including postpartum endometritis (p<0.05). Comparison of the sensitivity, specificity, positive probability ratio, positive and negative predictive values of leukocytosis and C-reactive protein with reliable markers of inflammatory diseases by means of the method mentioned above, were obtained the best results.

Conclusions. Spectral-fluorescent properties of blood serum are the reliable markers for the diagnosis of inflammatory diseases in obstetric-gynecologic practice.

Key words: postpartum endometritis, purulent-inflammatory diseases, method of fluorescence spectroscopy.

References

1. Bulavenko OV, Ostap’yuk LR, Rud' VO, Voloshinovs'kiy AS. 2015. Aprobatsіya metodu fluorestsentnoї spektroskopії dlya dіagnostiki pіslyapologovikh gnіyno-septichnikh uskladnen'. Vіsnik VNMU. 19(1): 161-167.

2. Astakhov VM, Sviridova VV, Bylym GV. 2000. Etiologiya, patogenez, klinika, lechenie i profilaktika poslerodovogo endometrita. Vіsnik asotsіatsії akusherіv-gіnekologіv Ukraїni. K. 4(9): 77-84.

3. Boyko VІ. 2006. Ekhografіchnі osoblivostі pri rіznikh varіantakh gnіyno-zapal'nikh uskladnen' pіslya kesareva roztinu. Akusherstvo ta gіnekologіya: 65-69.

4. Vdoskonalennya rann'oї dіagnostiki gnіyno-septichnikh uskladnen': іnformatsіyniy list. Vіnnits'kiy natsіonal'niy medichniy unіversitet іmenі M. І. Pirogova MOZ Ukraїni. 2014. Kiїv: 4.

5. Voronіn KV, Petrashenko TS, Demchenko TV. 2000. Gіsteroskopіya u dіagnostitsі ta lіkuvannі rіznomanіtnikh form pіslyapologovogo endometritu. Pedіatrіya, akusherstvo ta gіnekologіya. 3(379): 115-117.

6. Gryzunov YuA, Dobretsov GE (red). 1998. Al'bumin syvorotki krovi v klinicheskoy meditsine. M, GEOTAR: 440.

7. Gryzunov YuA, Dobretsov GE. 1998. Provedenie izmereniy parametrov EKA i OKA na analizatore AKL-01 v Al'bumin syvorotki krovi v klinicheskoy meditsine. M, GEOTAR: 104-107.

8. Krasnopol'skiy VI, Buyanova SN, Shchukina NA. 2007. Akusherskiy sepsis kak reproduktivnaya problema. Akusherstvo i ginekologiya. 3: 38-42.

9. Krasnopol'skiy VI, Logutova LS. 2008. Real'nye puti snizheniya chastoty kesareva secheniya v usloviyakh sovremennogo vzglyada na perinatal'nuyu smertnost'. Akusherstvo i ginekologiya. (3): 15–20.

10. Lakovich Dzh. 1986. Osnovy fluorestsentnoy spektroskopi. M, Mir: 496.

11. Bulavenko OV, Ostap’yuk LR, Rud' VO, Voloshinovs'kiy AS. 2016. Obgruntuvannya dotsіl'nostі zastosuvannya metodu fluorestsentnoї spektroskopії v kompleksnіy dіagnostitsі pіslyapologovogo endometritu. Zdorov'ye zhenshchiny. 3(109): 71-75.

12. Gerich ІD, Bulavenko OV, Ostap’yuk LR, Voloshinovs'kiy AS, Myagkota SV. 2013. Pat. №76953 Ukraїna. A61V 17/00 G01N 33/48, G01N 21/64. Sposіb rann'oї dіagnostiki gnіyno-septichnikh uskladnen' za dopomogoyu metodu fluorestsentnoї spektroskopії. № 201207441; zayavl. 19.06. 2012; opubl. 25.01.2013. Byul. №2.

13. Serov VN. 2011. Profilaktika materinskoy smertnosti. Akusherstvo i ginekologiya. 7(1): 4–10.

14. Gerich ІD, Bulavenko OV, Ostap’yuk LR, Voloshinovs'kiy AS, Myagkota SV. 2015. Fluorestsentna spektroskopіya: mozhlivostі zastosuvannya v medichnіy praktitsі. L, Lіga-Pres: 366.

15. Khachkaruzov SG. 2004. UZI v ginekologii. Simptomatika. Diagnosticheskie trudnosti i oshibki. Cankt-Peterburg: 661.

16. Chernitskiy EA, Slobozhanina EY. 1989. Spektral'nyy lyuminestsentnyy analiz v meditsine. Minsk, Nauka i tekhnika: 141.

17. Acosta C. 2014. Severe maternal sepsis in the UK, 2011-2012: a national case-control study. PLoS Med. 11(7): e1001672. https://doi.org/10.1371/journal.pmed.1001672; PMid:25003759 PMCid:PMC4086731

18. Cantwell R. 2011. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 118(1): 1-203. PMid:21356004

19. Clark S. 2008. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 199(1): 36.e1–36.е5.

20. Gerych I, Bulavenko O, Ostapiuk L. 2014. Spectral-fluorescent properties of serum as a reliable marker for early diagnosis of sepsis. Journal of Gynecology and Obstetrics. 2(5): 71-74. https://doi.org/10.11648/j.jgo.20140205.11.

21. Van Dillen J. 2010. Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis. 23(3): 249-54. https://doi.org/10.1097/QCO.0b013e328339257c; PMid:20375891

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