AIM OF STUDY

Analysis of clinical and laboratory-instrumental signs in delivering women with uterine subinvolution.

MATERIAL AND METHODS

We examined 58 delivering women with subinvolution of the uterus without clinical signs of an infectious-inflammatory process (group 1); 61 delivering women with subinvolution of the uterus with minor clinical signs of inflammation (group 2) and 38 delivering women with subinvolution of the uterus complicated by postpartum hypotonic endometritis — PHE (group 3).

RESULTS

Diagnostic criteria for subinvolution of the uterus without clinical signs of an infectious-inflammatory process have been established: leukocytosis level up to 10·10⁹/l, number of stab neutrophils 3-4%, ESR up to 20 mm/h, hsCRP less than 10 mg/l, leukocyte intoxication index (LII) less than 1 unit, phospholipase A₂ (PLA₂) 2.5-4.0 IU/l; resistance index (IR) of the uterine arteries less than 0.5; expansion of the uterine cavity up to 15 mm according to ultrasound; subinvolution with insignificant clinical signs of inflammation — leukocytosis 10-11·10⁹/l, the number of stab neutrophils 5-7%, ESR 30 mm/h, hsCRP 10-20 mg/l, LII 1-3 units, PLA₂ 4.0-7.0 IU/L, IR of the uterine arteries less than 0.5, expansion of the uterine cavity 15-20 mm; PHE — leukocytosis level 12·10⁹/l and more, number of stab neutrophils 8% or more, ESR more than 30 mm/h, hsCRP more than 20 mg/l, LII more than 3 units, PLA₂ more than 7.0 IU/l, IR uterine arteries less than 0.5, expansion of the uterine cavity more than 20 mm.

CONCLUSIONS

An algorithm has been developed for the diagnosis of clinical variants of postpartum subinvolution of the uterus and hypotonic endometritis that develops in delivering women against the background of subinvolution of the uterus.