The Role of Lipid Peroxidation and Activity of The Blood Antioxidant System in The Development of Postpartum Endometritis and Their Prognostic Significance

Аннотация

Postpartum endometritis is one of the most common infectious complications in the postpartum period. According to various authors, the incidence of endometritis after natural childbirth is 1-3%, while after cesarean section, the rate is 27% [3,5,12,13,18]. The frequency of cesarean sections in Uzbekistan has been steadily increasing from 9.58% in 1999 to 16.10% in 2019. In perinatal centers of Uzbekistan in 2017-2020. Thus, the determining of predictor factors which play huge role in the development of postpartum endometritis is relevant. In this article are given the results of scientific work which was done with 89 women who were after delivery in order to predict postpartum endometritis. Keywords: Endometritis, postpartum period, lipid peroxidation, antioxidant system, systemic inflammation, postpartum sepsis, malon dialdehyde. Introduction: Postpartum endometritis is one of the in 2019. In perinatal centers of Uzbekistan in 2017- most common infectious complications in the 2020. Moreover, the frequency of indications for CS postpartum period. According to various authors, the also increased and was noted: the frequency of CS incidence of endometritis after natural childbirth is 1- operations in perinatal centers in 2017 was 29.5%, in 3%, while after cesarean section, the rate is 27% 2018 - 33.2%, in 2019 - 34.5% and in 2020 - 34.3%. [3,5,12,13,18]. At the same time, postpartum Although there are many factors that increase the risk endometritis is the main cause of death associated with of developing intrauterine infection in the postpartum purulent-septic complications occurring on the 3-7th period, the most common of them are: young maternal day after childbirth. [15]. Cesarean section is associated age; different somatic diseases in the anamnesis: with a 5- to 10-fold increase in the incidence of immunosuppressive disorders, obesity, diabetes, postpartum infections and endometritis compared taking corticosteroid supplements; complications with vaginal delivery [15]. Moreover, the incidence of during antenatal period or delivery: decreased postpartum endometritis is approximately ten times frequency of antenatal care, chorioamnionitis, history higher in cesarean sections performed after the onset of repeat cesarean section, emergency cesarean of labor than in elective ones [16]. To reduce obstetric section, stapled wound closure, and excessive blood complications, the frequency of caesarean sections loss [1]. recommended by WHO should not exceed 15–30% of Inflammation is the basis of most diseases associated the total number of births. with postpartum infectious pathology. The The frequency of cesarean sections in Uzbekistan has inflammatory process is initiated by microbial, viral or been steadily increasing from 9.58% in 1999 to 16.10% fungal infections and / or systemic pathology of various International Journal of Medical Sciences And Clinical Research 96 https://theusajournals.com/index.php/ijmscr International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265) genesis, leading to tissue damage or autoimmune endometritis is relevant and the aim of our work was to reactions. Currently, in obstetrics and gynecology, the study the prognostic significance of lipid peroxidation prognostic potential of hematological markers of and the activity of the antioxidant system of the blood inflammation and processes associated with in the early postpartum period in the development of inflammation is widely used, studies are carried out on postpartum endometritis. the role of the systemic inflammatory state of a METHODS pregnant woman and a woman in labor in the prenatal During the study were collected 89 women who were and postpartum periods in the development of PE. The after delivery. Main group consist of 66 women after severity of the inflammatory state is assessed using labor with postpartum endometritis and they were immunological, biochemical and physiological changes, divided in to three subgroups according to the severity markers of which are proinflammatory chemical of endometritis: 23 with mild; 22 with moderate and 21 mediators of inflammation, such as chemokines, with severe type. The control (comparison) group cytokines, vasoactive amines, eicosanoids and consisted of 23 women after labor with a physiological proteolytic cascade products, the levels of which are course of the postpartum period. important prognostic markers of PE development. All parturient women were assessed for lipid Systemic inflammation is associated with changes in peroxidation levels and AOS enzyme activity on day 3 the number and function of blood cell components. postpartum. Using standard aseptic precautions, 5 ml Hematological markers are considered to be a of venous blood from the antecubital vein was reflection of the systemic inflammatory environment. collected into a polyethylene Stoppard tube containing The neutrophil-to-lymphocyte ratio is widely used to 60 μl of the anticoagulant k3 EDTA (tripotas