RESUMO
Postpartum endometritis is a common complication of cesarean section, the progression of which often leads to the loss of the uterus and the patient's fertility. We evaluated a detoxification therapy for treating patients with postpartum endometritis using an intrauterine application of a modified molded sorbent containing polyvinylpyrrolidone. A retrospective, controlled study included 124 patients with postpartum endometritis. The study group, n = 63, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial therapy in combination with the intrauterine application of a molded modified sorbent containing polyvinylpyrrolidone (FSMP) for 24 h daily for 5 days. The control group, n = 61, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial treatment only. The uterine cavity was infected by coccal flora (Enterococcus faecalis (26.6%), Staphylococcus spp. (21.3%), E. faecium (14.3%), and Gram-negative Escherichia coli (9.6%). A combination of these microorganisms was present in 40.5% of crops. Antibiotic resistance was detected in 53.6%-68.3% of the cases. In the study group, we observed: a faster and higher decrease in neutrophils (p < 0.05); a lower uterine concentration of pro-inflammatory cytokines: interleukin-1 beta (IL-1ß) and tumor necrosis factor α (TNFα) - 4.0 and 3.2 times, respectively, compared with the control group (p < 0.05); and a significant decrease in the uterus volume and cavity (M-echo). Using a newly modified sorbent associated with antibiotic treatment in patients with postpartum endometritis, compared with antibiotics alone, we showed a sharp reduction of inflammatory parameters, residual microorganism growth, and faster uterine volume involution. Moreover, the frequency of hysterectomy decreased by 14.4 times.
