Modern tactics of observation the postpartum purulent-septic complications

Abstract

Introduction.

Postpartum purulent-septic diseases remain an urgent problem of modern obstetrics and are one of the important causes of maternal mortality. The presence of lethal proceeds from septic complications in the postpartum period is above all due to late diagnosis of this complication, delayed acceptance decision on the need and extent of surgery, inadequate capacity of syndromic and intensive care.

The aim of research.

The clinical analysis of different methods of diagnosis and treatment of patients with postpartum purulent-septic complications, obtained during the period from January 2011 to June 2013, based on work of gynecological department of Zaporozhye Regional Clinical Hospital.

Materials and methods.

During the period from January 2011 to June 2013 in the gynecological department of Zaporozhye Regional Clinical Hospital specialized medical care of 30 patients with purulent-septic complications in the postpartum period have been provided. 5 women in labor (16.67%) were transferred from the maternity homes of Zaporozhye city and the rest (83.33%) from different regions.

Results.

All patients admitted to gynecology department of Zaporozhye Regional Clinical Hospital were conducted massive antibiotic, syndromic therapy. 11 additional patients had an operation vacuum aspiration contents of the uterus, and 5 mothers had absolute indications for surgery: hysterectomy with uterine tube (2 patients diagnosed - septic condition, 3 cases - failure scar on the uterus after cesarean).

Conclusion.
1. Delivery by cesarean section surgery significantly increases the risk of developing pyo-septic complications. Prompt delivery should be made according to strict indications, using modern sutures , intraoperative blood loss objective assessment (if necessary with timely appointment of replacement therapy and anti-anemic ), with mandatory drainage of the abdominal cavity with repeated cesarean operations .
2. Using the entire set of clinical, laboratory, and additional methods (procalcitonin) study contribute to the earliest possible diagnosis of purulent -septic complications in the postpartum period .
3. Upon receipt of objective data for developing postpartum purulent- septic complications of a woman in labor is subject to immediate transfer to specialized hospitals of the 3^rd  levels of care. Optimal time transfer is 2-3 days postpartum.
4. Identifying patients with medium and high risk of developing of the pyo-septic complications should be performed on the stage and antenatal clinic surveillance in the family doctor.