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Opportunities for early diagnostics of contemporary obstetric sepsis

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.183

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Abstract

Aim: to objectively assess potential for early generalized postpartum infection diagnostics prior to the onset of irreversible organ changes based on a retrospective analysis.

Materials and Methods. Сlinical and laboratory forensic medical data were examined by analysing 29 cases of severe maternal outcomes coupled to sepsis: including 17 «near miss» and 12 deceased patients (maternal mortality). The control group consisted of 30 patients who had chorioamnionitis in labor and successfully completed pregnancy. Statistical data analysis was carried out by using nonparametric statistics by creating conjugacy tables and assessing a relationship between parameters with Pearson χ2 distribution.

Results. There were found significant differences in rate of some symptoms in both groups. Patients with severe maternal outcomes vs. control group were significantly more likely to develop hyperthermia ≥ 38.0 °C or hypothermia ≤ 36.0 °C, hectic fever, leukocytosis ≥ 12×109/L or leukopenia ≤ 4×109/L before the end of pregnancy; after pregnancy, persistent subfebrility, febrility or hypothermia, hectic fever, multiple-organ failure syndrome (PON), as well as uterine subinvolution and abnormal discharge from the genital tract were observed.

Conclusion. Early identification of recognized symptoms of systemic inflammatory response syndrome and PON allows to properly assess severity of patient condition, taking into account the risk of generalized infection, contributes to making correct diagnosis and timely implementation of adequate organizational and therapeutic measures.

About the Authors

V. F. Bezhenar
Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation
Russian Federation

Vitaly F. Bezhenar – MD, Dr Sci Med, Professor, Head of the Department of Obstetrics, Gynecology and Reproductology

6–8 Lev Tolstoy Str., Saint Petersburg 197022



V. A. Shapkaitz
Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation; Saint Petersburg Maternity Hospital № 16
Russian Federation

Vladimir A. Shapkaitz – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Reproductology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; Chief Physician, Saint Petersburg Maternity Hospital № 16

6–8 Lev Tolstoy Str., Saint Petersburg 197022;
54 Malaya Balkanskaya Str., Saint Petersburg 192283



I. A. Dobrovolskaya
Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation
Russian Federation

Irina A. Dobrovolskaya – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Reproductology

6–8 Lev Tolstoy Str., Saint Petersburg 197022



E. A. Rukoyatkina
Saint Petersburg Maternity Hospital № 16
Russian Federation

Elena A. Rukoyatkina – MD, PhD, Deputy Chief Physician

54 Malaya Balkanskaya Str., Saint Petersburg 192283



I. M. Nesterov
Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation
Russian Federation

Igor M. Nesterov – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Reproductology

6–8 Lev Tolstoy Str., Saint Petersburg 197022



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For citation:


Bezhenar V.F., Shapkaitz V.A., Dobrovolskaya I.A., Rukoyatkina E.A., Nesterov I.M. Opportunities for early diagnostics of contemporary obstetric sepsis. Obstetrics, Gynecology and Reproduction. 2021;15(2):121-131. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.183

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)