Мать и дитя в Кузбассе (Jan 2024)
ANALYSIS OF THE STRUCTURE AND DYNAMICS OF POSTPARTUM DISEASES IN NOVOKUZNETSK (2020-2022)
Abstract
Among the causes of maternal mortality in the Russian Federation, infectious and inflammatory diseases after childbirth and abortion occupy fourth position. A systematic analysis of the prevalence, structure and dynamics of postpartum diseases is necessary for making adequate organizational decisions. The purpose of the study – to study the frequency, structure and dynamics of postpartum diseases in Novokuznetsk for the period 2020-2022. Research methods. The analysis was carried out according to the reporting documentation of the gynecological department N 2 of the Novokuznetsk City Clinical Hospital N 1 named after G.B. Kurbatov for 2020-2022. Comparisons were made using the Cochran-Mantel-Haenszel test (pgr) with the calculation of the generalized Mantel-Haenszel odds ratio and its 95% confidence interval. Differences were considered statistically significant at p ≤ 0.05. For calculations and plotting, the statistical environment R (v.3d.6, GNU GPL2 license) was used. Results. The prevalence of postpartum diseases during the studied period varies from 6.1 ‰ to 20.1 ‰. Infection of an obstetric surgical wound (29 %) and postpartum endometritis (16 %) were more often recorded. The incidence of postoperative suture seroma and suture failure on the uterus with the development of peritonitis has increased significantly. Postpartum diseases were more often observed in women over 35 years of age, with 3 or subsequent births and high morbidity. In 45.6 % of cases, the diseases were associated with a bacterial factor, while the frequency of detection of microbial associations of opportunistic flora, E. Faecalis and S. Aureus increased 7-8 times. Conclusion. The prevalence of postpartum infectious and inflammatory diseases during the study period remains consistently high. To reduce the incidence of complications in the postpartum period, a balanced approach to the choice of delivery method and a reduction in the length of stay in the obstetric hospital are necessary. At the stage of pre-pregnancy preparation, the following are necessary: timely identification and sanitation of foci of infection, effective diagnosis and treatment of anemia with normalization of weight before pregnancy.
