Topicality of the problem of obstetric and gynecological sepsis

V.G. Karpenko, N.M. Pasiyeshvili

Abstract


The creation and use of newest antibacterial drugs in clinical practice, the development and introduction of methods for the prevention of purulent-septic complications in obstetric and gynecological practice did not lead to the disappearance and a significant decrease of inflammatory complications in this field of medicine. Infectious complications continue to occupy one of the leading places in the structure of both obstetric and gynecological morbidity and maternal mortality. One of the most severe complications is the sepsis and septic shock. Therefore, relevance of this problem is beyond doubt. Now, even in the countries with the high level of the medical and social care to the population, the average level of mortality with sepsis makes 35 %, and in patients with septic shock reaches 60–70 %. The second important point at the present stage of the development of pharmacological scien­ce and industry in terms of creating new antibacterial drugs is the problem of constant transformation of microorga­nisms, which may have a resistance to these drugs and which can cause inflammation in the mother and fetus. During the pregnancy: amnionitis, chorioamnionitis, fetal pneumonia, premature births and in the puerperal period: metroendometritis, peritonitis, various postoperative complications, perinatal losses, etc. In the last decades, against the background of aerobic-anaerobic flora with participation of opportunistic autoflora, the significant role in these associations is played by infections, which are transmitted sexually: chlamydias, mycoplasma, viruses, trichomonads, gonococci, etc. An important role in the development of infectious complications is played also by a physiological immunosuppression during pregnancy.

Keywords


obstetric and gynecological sepsis; pathogenesis; classification; diagnosis; treatment; review

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DOI: https://doi.org/10.22141/2224-0586.3.82.2017.102332

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