• Reproductive anamnesis of women with postpartum purulentQseptic complications

Reproductive anamnesis of women with postpartum purulentQseptic complications

HEALTH OF WOMAN. 2017.6(122):65–68; doi 10.15574/HW.2017.122.65

Pyrohova V. I., Feyta Y. R.
Lviv national medical University named Danylo Galitsky

Postpartum purulent-septic complications are considered to be one of the main causes of maternal loss, hence, this is why they continue to maintain their relevance and priority in modern obstetrics. The incidence of this disease remains high and aggravates the extension of the postpartum period in 5–26% of cases. Mostly postpartum purulent-septic complications are caused by not one, but a combination of several reasons that can act simultaneously or sequentially and are often caused by a combination of medical and social factors. These factors require the necessity of diligent analysis of the reproductive anamnesis of women who suffered from complications of septic nature during the postpartum period, in order to highlight the risk factors for these complications.

The objective: to explore the possibility of formation of high-risk groups based on the analysis of reproductive anamnesis in women with postpartum purulent-septic complications as part of preventive measures.

Patients and methods. According to the purpose of this research a detailed retrospective analysis was made of anamnesis histories of 89 women (study group) with postpartum septic complications, namely, 58 women with postpartum purulent-septic complications who bore through natural birth canal; 31 women with postpartum purulent-septic complications after cesarean section.

The control group consisted of 40 women recently confined within uncomplicated maternal postpartum process.

Results. It was investigated that in the group of women with postpartum complications prevailed women who were pregnant for the second time (especially after cesarean section).It is important to highlight the fact that significant percentage of menstrual disorders and the commencement of early sexual live of women in the study group. Analysis of an illness revealed a significant incidence of inflammatory diseases of the female reproductive organs, cervical pathology, chronic tonsillitis, chronic pyelonephritis, cystitis, anemia clinical history in the main group. Significant percentage is noticed of the women with thyroid disorders. Significantly higher frequency was noticed with regards to pregnancies that had negative consequences in anamnesis, the presence of gynecological pathology, surgery and vaginal microbiota disturbances before and during pregnancy in women with postpartum purulent-septic complications. A combination of two or more selected factors, especially in women with extragenital pathology and transferred infectious diseases in anamnesis, greatly increases the risk of septic complications in the postpartum period.

Conclusions. Current analysis has provided implicit evidences to ensure that it is important to select a separate group at high risk of postpartum septic complications on the stage which precedes pregnancy for the development of an individual plan for diagnostic and preventive measures to prevent this disease.

Key words: postpartum purulent-septic complications, risk factors, reproductive anamnesis.

REFERENCES

1. Bakterialnyiy sepsis vo vremya beremennosti: Rukovodstvo korolevskogo kolledzha akusherov i ginekologov (Velikobritaniya, 2012). Reproduktivnaya endokrinologiya. 2012. 5:76–81.

2. Vdovychenko YuP, Shlapak IM. 2015. Povtornyi kesariv roztyn: diahnostyka i profilaktyka perynatalnoi patolohii, vidnovlennia reproduktyvnoho zdorovуa. Zdorove zhenshchynу 3:153–155.

3. Dolgoshapko ON. 2012. Sindrom sistemnogo vospalitelnogo otveta v akusherstve. Zdorov’ya Ukrainy. Temat. nomer: Ginekologiya. Akusherstvo. Reproduktologiya. 1:44–46.

4. Osnovyi reproduktivnoy meditsinyi. Prakt. rukovodstvo. Pod red. VK Chayki. D, Almateo. 2011:275–321.

5. Mokryk OM, Davydova YuV, Apresova KH, Ohorodnyk AO. 2012. Rol vyskhidnoi infektsii u vahitnykh z ekstrahenitalnoiu patolohiieiu. Zdorove zhenshchynу 1:134–136.

6. Shestakova OI, Podrez LA, Baranov II, Pyiregov AV. 2011. Rol endotoksina v diagnostike oslozhneniy poslerodovogo perioda. Akusherstvo i ginekologiya 6:53–57.

7. Skrypchenko NIa, Pavlova OM. 2014. Profilaktyka ta likuvannia hniino-septychnykh uskladnen u pisliapolohovomu periodi u zhinok iz polohovoiu travmoiu. Reproduktyvnaia эndokrynolohyia 5:33–36.

8. Tkachenko RA, Kaminskiy VV. 2014. Sovremennaya profilaktika, diagnostika i lechenie posleoperatsionnyih infektsiy v akusherstve i ginekologii. Zdorov’ya UkraYini. Temat. nomer: GInekologIya. Akusherstvo. ReproduktologIya. 4:32–33.

9. Churilov A, Butina L. 2011. Sovremennyie aspekty kesareva secheniya u beremennyih s infektsionnyim riskom. Z turbotoyu pro zhinky 3:3–6.

10. Al-Ostad G, Kezouh A, Abenhaim H. 2015. Incidence and risk factors of sepsis mortality in labor, delivery and postpartum: a population-based study on 5 million births. Am. J. Obstet. Gynecol. 212;1:241–242. https://doi.org/10.1016/j.ajog.2014.10.521

11. Anbazhagan A, Harper A. 2015. Postpartum pyrexia. Obstet., Gynaecol. Reproduct. Med. 25;9:249–254. https://doi.org/10.1016/j.ogrm.2015.06.004

12. Bamfo JEAK. 2013. Managing the risks of sepsis in pregnancy. Best Practice & Research: Clinical Obstetrics and Gynaecology 27;4:583–595. https://doi.org/10.1016/j.bpobgyn.2013.04.003; PMid:23639681

13. Cox S, Reid F. 2015. Urogaecological complications in pregnancy: an overview. Obstet., Gynecol. Reproduct. Med. 25;5:123–127. https://doi.org/10.1016/j.ogrm.2015.02.002

14. Frise CJ, Frise MC, Nelson-Piercy C. 2015. Management of the critically-ill obstetric patient. Obstet., Gynaecol. Reproduct. Med. 25;7:188–194. https://doi.org/10.1016/j.ogrm.2015.04.002

15. Bonet M, Oladapo OT, Khan DN et al. 2015. New WHO guidance on prevention and treatment of maternal peripartum infections. Lancet Global Health. 3;11:667–668. https://doi.org/10.1016/S2214-109X(15)00213-2

16. Nicoll A, Chien PFW, Mahmood T. 2012. Community-acquired genital tract infection and pregnancy. Obstet., Gynaecol. Reproduct. Med. 22;9:248–253. https://doi.org/10.1016/j.ogrm.2012.06.005