On the choice of a solution for cavitation in the complex treatment of postpartum endometritis

Background. Postpartum endometritis is an infectious and inflammatory process in the endometrium with possible involvement of the myometrium. The main components of the treatment of the disease are antibiotic therapy and removal of necrotic contents of the cavity of the postpartum uterus. From the point of view of caring for the organ, ultrasonic cavitation looks preferable. To increase its effectiveness, various solutions with antiseptic, immunomodulatory or other properties can be used.

Objective. The purpose of our study was a comparative assessment of the effectiveness of the use of various liquids during ultrasonic cavitation in the treatment of postpartum endometritis.

Materials and methods. 80 patients with mild and moderate severity of the disease were examined and treated. The patients were divided into 4 groups of 20 women: 1) patients of the 1st group received treatment according to the clinical recommendations of the Ministry of Health of the Russian Federation; 2) patients of the 2nd group underwent ultrasound cavitation of the uterine cavity using 0.9% sodium chloride solution; 3) patients of the 3rd group underwent ultrasound cavitation followed by additional irrigation of the uterine cavity 0.25% sodium deoxyribonucleate solution; 4) ultrasound cavitation of the uterine cavity was performed in patients of the 4th group using 0.9% furacilin solution.

Results. On the 7th day of treatment for postpartum endometritis, all patients showed an improvement in well-being and objective indicators. At the same time, incomplete reduction of uterine soreness during palpation by the 7th day in patients of the 1st and 3rd groups led to an increase in bed days in these groups. In patients of group 1, there was a slower dynamics of blood parameters such as leukocyte count, C-reactive protein and erythrocyte sedimentation rate. The degree of reduction of tumor necrosis factor alpha and interleukin-10 was the lowest in group 1 and the highest in group 4. The bed day turned out to be the smallest in group 4 and the largest in group 1.

Conclusion. Ultrasound cavitation of the uterine cavity significantly increases the effectiveness of complex therapy of postpartum endometritis and shortens the duration of treatment of patients, enhances the positive effect of ultrasonic cavitation by using 0.9% furacilin solution in a dilution of 1: 5000 as a cavitation liquid. Irrigation of the uterine cavity with a solution of sodium deoxyribonucleate does not significantly affect the healing process.

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