Introduction. One of the leading places in the structure of gynecological diseases is occupied by postpartum complications.Aim: to study the clinical and laboratory features of the development of postpartum inflammatory complications.Materials and Methods. On the basis of the Research Institute of Obstetrics and Gynecology of the Ministry of Health of the Republic of Azerbaijan (Baku) in the period from 2019 to 2021 150 puerperas were examined, among which 2 groups were distinguished: the main group – puerperas with developed postpartum complications (n = 100) at the age of 29.9 ± 0.64 years and the control group – puerperas with a physiological course of the postpartum period (n = 50) at the age of 30.3 ± 0.86 years (p = 0.679). We studied the general and obstetric-gynecological anamnesis. The following structural elements of the blood were determined: the total number of leukocytes, the absolute and relative values of lymphocytes, the number of erythrocytes and platelets, the concentration of hemoglobin, the erythrocyte sedimentation rate, and the quantitative determination of interleukin-6 (IL-6).Results. In puerperas of the main group, as additional risk factors for the development of postpartum complications relative to the control group an increase in the level of pro-inflammatory cytokines from 24.26 ± 0,48 pg/ml vs. 10.36 ± 0,62 pg/ml (p = 0.001). In the reactions of cellular immunity, there is a decrease in the ratio of CD4+/CD8+ due to an increase in the number of CD8+ lymphocytes in the blood and a decrease in the subpopulation of CD4+ lymphocytes. The development of postpartum inflammatory complications is associated with menstrual disorders in 81.0 ± 3.92 % of cases, first births in 60.0 ± 4.90%, threatened miscarriage in 19.0 ± 3.92 % and gestosis in 52.0 ± 5.00 % of the total number of patients in the main group. Some risk factors are associated with diseases of the genitourinary system (chronic pyelonephritis 24.0 ± 4.27 % and 10.0 ± 4.24 %, respectively, in the main and control groups; p = 0.048) and respiratory organs, most often represented by chronic tonsillitis and sinusitis (20.0 ± 4.00 % vs. 4.0 ± 2.77 % in the control group; p = 0.007).Conclusion. The course of the postpartum period in primiparas and in women with a burdened history of obstetric-gynecological and extragenital pathology is characterized by a high percentage of inflammatory complications. Biochemical studies with the determination of T-lymphocytes in the blood serum and the level of the pro-inflammatory cytokine IL-6 can be used as an additional diagnostic method to identify, assess the nature and severity of early puerperal complications.

The postpartum period is a sensitive time when mothers are subjected to increased risks of mental disorders. Aim: to study the structure of anxiety and depressive disorders in women against the background of the early postpartum complications. Material and methods. 150 patients, who underwent inpatient treatment at the Scientific Research Institute of Obstetrics and Gynecology, Baku, were selected for the study and divided into two groups: the main group - with postpartum complications (n = 100), the comparison group — with physiological postpartum period (n = 50). The average age was 29.9 ± 0.64 and 30.3 ± 0.86 years. All patients underwent a comprehensive examination using anamnestic data and the Hamilton Scale to assess the severity of anxiety (HARS) and depression (HRDS). Results. According to etiology and pathogenesis, the studied pathology is multifactorial. Significant risk factors for the complicated course of puerperia are inflammatory diseases of the pelvic organs. Attention is drawn to the adverse effect on the health of women in the puerperal period, the high frequency of diseases of the upper respiratory tract and kidneys in the anamnesis. Diagnosed postpartum inflammatory complications may serve as a risk factor for the development of anxiety and depressive disorders in the postpartum period. The average indicators in women of the control group are within the normal range. A high level of clinical severity of symptomatic anxiety was observed in the main group (48.0 + 5.00% versus 8.0 + 3.84% in the control group, χ2 = 44.19; p < 0.0001), that is, early postpartum complications are a predictor of severe anxiety. Depression of an average degree was more often recorded with a complicated course of puerperia. Discussion. The presence of a burdened obstetric and gynecological anamnesis and extragenital pathology increases the risk of puerperal complications and the development of severe affective disorders. Changes in the emotional status affecting the anxious and depressive component were more often revealed in postpartum women with complications than in women with a physiological course of the postpartum period. Conclusions. Most of the anxiety-depressive conditions in the main group corresponded to moderate severity in the clinical and psychopathological study. Disorders of mild degree were observed more often in a physiologically proceeding postpartum period. When complications are detected, timely diagnosis and correction of anxiety and depressive disorders are necessary for easily women’s adaptation to the postpartum period.

Background. The main etiological reasons for the still high level of serious postpartum complications are frequent isolation of aggressive pathogenic microorganism associations, an increase in their virulence and antibiotic resistance, and an increase in the frequency of surgical methods of delivery. Aim. Assessment of the significance of clinical, instrumental and laboratory parameters in the diagnosis of early inflammatory complications of the postpartum period. Material and methods. To study the risk factors for the development of the inflammatory process, they were registered in the postpartum period during the examination of 150 patients who underwent inpatient treatment at the Scientific Research Institute of Obstetrics and Gynecology in Baku for the period 20172020. Depending on the presence or absence of the studied pathology, the patients were divided into two groups: the main group included puerperas with developed postpartum complications (n=100), the comparison group included puerperas with a physiological course of the postpartum period (n=50). The average age of puerperas in groups was 29.90.64 and 30.30.86 years, respectively (p=0.679). Complications were diagnosed based on the analysis of the results of clinical and laboratory studies, the study of anamnestic data and the results of ultrasound examination. The information content of the obtained data was determined by the Kullback method. Results. In the course of research, it was found that an important reason for the development of postpartum complications of an inflammatory nature is the long-term use of contraception. Women of the main group more often use means for intrauterine contraception and barrier contraceptives 24 and 29%, and in the comparison group 6 and 12% (p=0.006; p=0.024). When studying the structure of clinical manifestations of complications of the early postpartum period, pain in the lower abdominal cavity was most often recorded 89.03.13%, and in the comparison group 6.03.36% (p 0.0001). Among the studied ultrasound diagnostic criteria for inflammatory complications in the postpartum period, cases of an increase in the size of the uterus and thickening of the endometrium were detected in 98 and 97 out of 100 people in the main group and only in 1 case out of 50 patients in the comparison group (p 0.0001). The absolute number of T-lymphocytes, hemoglobin, the concentration of the pro-inflammatory cytokine interleukin-6, and the erythrocyte sedimentation rate are recognized as the most informative diagnostic indicators of biochemical studies in patients with postpartum complications. Conclusion. The reasons for the development of inflammatory complications in the postpartum period are the presence of a history of spontaneous abortions, intrauterine contraception and the use of barrier contraceptives.