[Structural changes in the endometrium of puerperae with high risk of development of endometritis in the postpartum period]. / Strukturnye izmeneniia éndometriia u rodil'nits s vysokim riskom razvitiia éndometrita v poslerodovom periode.

The endometrium of 72 puerperae referred to a high-risk group in respect of developing infectious complications was examined on days 3-18 of the puerperium. The periods of epithelialization and regeneration onset in abnormal course of the puerperium were detected, and the morphologic criteria of these processes specified. In cases with cesarean sections these processes started 2-3 days later than after spontaneous delivery. Bacteriologic examination of the uterine cavity contents is an indirect test for the detection of an infection; the final diagnosis may be made only after a comprehensive assessment of the endometrial status.

[Clinical-morphological parallels in postpartum endometritis]. / Kliniko-morfologicheskie paralleli pri poslerodovom éndometrite.

Clinicomorphologic parallels were studied in 45 puerperants with postpartum endometritis. This condition was histologically confirmed in 42 of the 45 patients with its clinical symptoms (in 100% of patients with the grave, in 95% with the medium-severity, and in 83% of those with the benign form of the disease). The authors came to the conclusion that the severity of postpartum endometritis was directly dependent on the extent and depth of the uterine wall involvement in the inflammatory process. By the end of treatment the morphologic signs of inflammation persisted in 40% of patients even without clinical signs of endometritis. Such women should be referred to a group at high risk of developing chronic endometritis.

[The importance of cytological study of lochia in assessing uterine function in the puerperal period]. / Znachenie tsitologicheskogo issledovaniia lokhii v otsenke sostoianiia matki v poslerodovom periode.

Cytologic analysis of lochia in 118 puerperae helped distinguish 5 types of cytograms. A normal postpartum period is characterized by a gradual transition from an inflammatory to regenerative type. Subinvolution of the uterus is associated with a prolonged persistence of the inflammatory regenerative type, this pointing to deceleration of endometrium purification processes. The inflammatory, degenerative-inflammatory, and necrotic cytogram types were characteristic of endometritis of varying severity. The necrotic cytogram type was found the most prognostically unfavorable.

[Diagnostic value of lochial pH, pCO2,and pO2 in puerperal endometritis]. / Diagnosticheskoe znachenie opredeleniia pH, pCO2 i pO2 lokhii pri poslerodovom endimetrite.

A new method has been developed for rapid diagnosis of puerperial endometritis, based on measurements of lochial pH, pCO2, and pO2. Endometritis development is associated with acidosis in the uterine cavity (pH 6.8-7.2), elevation of pCO2 to make 40-70 mm Hg, and reduction of pO2 to make 40-80 mm Hg. The degree of these shifts is in direct relationship with the inflammatory process severity. The method is simple, almost noninvasive, and quite reliable.