In modern obstetrics over the past few years, there has been a persistent trend towards an increase in the frequency of operative childbirth due to the expansion of indications for their conduct. Despite the improvement of surgical techniques, the use of antibiotic prophylaxis, the use of modern suture materials, the frequency of purulent-inflammatory postpartum diseases (PIPD) remains the same, amounting to up to 10% in the group of women after vaginal delivery and up to 20—25% after abdominal. At the same time, in case of emergency situations, the percentage of these complications increases significantly. The most severe complication of PIPD is obstetric sepsis, which accounts for not so many cases (up to 2—3%), but a significant proportion of these clinical situations end in death. The most common cause of obstetric peritonitis and sepsis is postpartum endometritis (PE), the frequency of which reaches 45—50% in the structure of PIPD, while PE most often leads to suppuration and divergence of sutures on the uterus and generalization of the infectious process.
OBJECTIVE
To analyze the literature data on the frequency and structure of septic postpartum diseases (SPD) after operative delivery.
MATERIAL AND METHODS
The review of foreign and domestic data found in the search databases eLibrary, Scopus, PubMed/MEDLINE for the period 2004—2023, dedicated to the SPD after abdominal delivery, is presented. The articles were searched by keywords: “caesarean section”, “postpartum endometritis”, “postpartum sepsis”, “obstetric peritonitis”, “obstetric sepsis”, “sepsis”, “septic shock”. When describing the data, only full-text sources, systematic and literary reviews on the stated topic were included. The study included full-text sources and literary reviews on the subject under study. When writing the presented review, literary data that are not directly related to the problem of obstetric sepsis and PIPD were excluded.
RESULTS
As a result of the conducted literary review, a small amount of information about the SPD attracts attention. Undoubtedly, PE occupies the lion’s share in the overall structure of the PIPD, while its frequency after abdominal childbirth is 2 times higher than after spontaneous ones. However, today we are dealing with the primary chronic course of PE, its late manifestation and the long-term generalization of the process. That is why it is extremely important to timely assess the local and general somatic status of a maternity hospital with PE, diagnose and adequately treat within an hour interval, since the risks of septic complications in such a cohort of patients are extremely high.
