Clinical Characteristics and Treatment Results of Women with Various Forms of Infectious and Inflammatory Diseases of the Postpartum Period

Abstract

Introduction. The issues of managing postpartum women with infectious and inflammatory diseases (IID) are extremely relevant in modern conditions.The aim of the study is to present the clinical characteristics and features of treatment of women in labor with various forms of postpartum pulmonary dysfunction.Materials and methods. A retrospective examination of 181 postpartum mothers with IID was carried out, who were divided into 3 groups: A (n = 122) — patients with uncomplicated endometritis; B (n = 43) — with complicated forms (suture failure, metrothrombophlebitis); C (n = 16) — with severe septic complications (parametritis, obstetric peritonitis).Results. In groups B and C, chorioamnionitis was statistically significantly more often diagnosed during labor compared to uncomplicated endometritis (pA–B = 0.002, pA–C < 0.001). In the integrated the number of points on the NEWS2 scale was statistically significantly higher in group B (p = 0.050) and group C (p = 0.007) compared to group A. In 25.42 % of the subjects, there was a discrepancy between the prescribed empirical antibacterial therapy and the pathogen isolated. In group B, organ-preserving surgery was performed in 55.81 % of the mothers on day 6.5 [4.8; 11.0], and hysterectomy was performed on day 9.0 [6.0; 12.0] after delivery.Conclusion. Chorioamnionitis during childbirth, a score on the NEWS2 scale of 2 or more points suggests the development of complicated forms of postpartum endometritis. When treating, preference should be given to antibiotics of the aminopenicillin group, amoxicillin and beta-lactamase inhibitors, carbapenems and a timely decision should be made on repeated surgical intervention, allowing for organ-preserving surgery.