A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Early Prognosis of Postpartum Endometritis

DOI:10.31550/1727-2378-2021-20-1-17-20
For citation: Batrakova T.V., Zazerskaya I.E., Vavilova T.V., Kustarov V.N., Khadzhieva E.D., Sokolova A.A. Early Prognosis of Postpartum Endometritis. Doctor.Ru. 2021; 20(1): 17–20. (in Russian). DOI: 10.31550/1727-2378-2021-20-1-17-20

Study Objective: To study the role of prompt assessment of WBC count and their neutrophil subpopulation, С-reactive protein (CRP) in prognosis of postpartum endometritis for prevention of severe purulent-septic complications and reduction in maternal mortality rates.

Study Design: retrospective cohort study.

Materials and Methods. The study included 199 maternity patients who were retrospectively divided into two groups: test group — maternity patients with postpartum endometritis (n = 72), and control group — maternity patients in normal postpartum period (n = 127).

Study Results. Diagnostic threshold limits were set on day 3 postpartum: WBC — 12.5 × 109/L, neutrophils — 72%. It was demonstrated that the isolated assessment of WBC and neutrophils count on day 3 postpartum does not provide significant clinical information for prognosis of postpartum endometritis. The risk of postpartum endometritis with diagnostic CRP threshold of 60 mg/L increases 12.5-fold. If these values are above the diagnostic levels (12.5 × 109/L, 72% and 60 mg/L, respectively), the risk of endometritis reaches 96%.

Conclusion. This method to predict postpartum endometritis allows identifying asymptomatic maternity patients with high risk of endometritis in obstetric settings, preventing severe purulent-septic postpartum complications and, therefore, is a measure to reduce maternal mortality.

Contributions: Zazerskaya, I.E., Vavilova, T.V., Kustarov, V.N. and Khadzhieva, E.D. — study design, review of critically important material, approval of the manuscript for publication; Batrakova, T.V. — collection of clinical materials, data processing, analysis and interpretation, manuscript preparation; Sokolova, A.A. — thematic publications reviewing.

Conflict of interest: The authors declare that they do not have any conflict of interests.

T.V. Batrakova (Corresponding author) — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. eLIBRARY.RU SPIN: 3042-2856. E-mail: tatyana_shuranov@mail.ru

I.E. Zazerskaya — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. eLIBRARY.RU SPIN: 5683-6741. Е-mail: zazera@mail.ru

T.V. Vavilova — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. eLIBRARY.RU SPIN: 9003-6455. Е-mail: Vavilova_TV@almazovcentre.ru

V.N. Kustarov — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. Е-mail: prof.kustarov@gmail.com

E.D. Khadzhieva — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. E-mail: tatyana_shuranov@mail.ru

A.A. Sokolova — V.A. Almazov National Medical Research Center; 2 Akkuratova Str., St. Petersburg, Russian Federation 197341. eLIBRARY.RU SPIN: 2423-0370. E-mail: alyona-sokolova@mail.ru

Доктор.ру

Fig. ROC-analysis of clinical informative value of WBC and neutrophil count: А — neutrophils (р = 10–12), B — WBC (р = 10–11)

r3_1.jpg 

Received: 24.09.2020
Accepted: 21.12.2020

LITERATURE
  1. Zhilinkova N.G. Modern concepts of puerperal infections in connection with antibacterial resistance and the end of the antibiotics era. Obstetrics and Gynecology: News, Opinions, Training. 2019; 7(3): 70–5. (in Russian). DOI: 10.24411/2303-9698-2019-13010
  2. Shifman E.M., Kulikov A.V., Gelfand B.R. et al., eds. Initial therapy of sepsis and septic shock in obstetrics. Clinical recommendations. М.; 2017. 27 p. (in Russian)
  3. Knight M., Chiocchia V., Partlett C. et al. Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial. Lancet. 2019; 393(10189): 2395–2403. DOI: 10.1016/s0140-6736(19)30773-1
  4. Plante L.A., Pacheco L.D., Louis J.M. SMFM Consult Series #47: sepsis during pregnancy and the puerperium. Am. J. Obstet. Gynecol. 2019; 220(4): PB2–B10. DOI: 10.1016/j.ajog.2019.01.216
  5. Axelsson D., Brynhildsen J., Blomberg M. Postpartum infection in relation to maternal characteristics, obstetric interventions and complications. J. Perinatal Med. 2018; 46(3): 271–8. DOI: 10.1515/jpm-2016-0389
  6. Bettikher O.A., Zazerskaya I.E., Popova P.V. et al. Preeclampsia features in pregnancy with gestational diabetes mellitus. Journal of Obstetrics and Women’s Diseases. 2019; 68(5):19–36. (in Russian). DOI: 10.17816/JOWD68519-36
  7. Novikova T.V., Zazerskaya I.E., Kuznetsova L.V. et al. Vitamin D and mineral metabolism after childbirth with the use of preventive doses of cholecalciferol. Journal of Obstetrics and Women’s Diseases. 2019; 68(5): 45–53. (in Russian). DOI: 10.17816/JOWD68545-53
  8. Wong A.W., Rosh A.J., Talavera F. et al. Postpartum infections clinical presentation. 2018. URL: https://emedicine.medscape. com/article/796892-clinical (Accessed October 15, 2020).
  9. Velkov V.V. Comprehensive laboratory diagnostics of systemic infections and sepsis: C-reactive protein, procalcitonin, presepsin. M.: ZAO “DIAKON”; 2015. 117 p. (in Russian)
  10. Batrakova T.V., Vavilova T.V., Osipova N.A. Role of acute-phase proteins in post-partum endometritis diagnostics (review of literature). Gynaecology. 2016; 18(1): 37–9. (in Russian). DOI: 10.26442/2079-5696_18.1.37-39
  11. Anokhova L.I., Belokrinitskaya T.E., Pateyuk A.V. et al. Postnatal endometritis and its prevention (review of literature). Science Review. Medical Science. 2016; 4: 6–13. (in Russian)

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