RU2234925C1 - Method for prophylaxis of suppurative-septic complications in mothers after cesarean delivery - Google Patents

Abstract

FIELD: medicine, obstetrics.

SUBSTANCE: method involves every day

of intravenous ozone therapy after surgery for 5-6 days on the background of intake of wobenzym that is given 3 days before operation and 5-6 days after operation. Method allows activating oxidative-reductive and deintoxication processes, immunity, to exhibit the expressed anti-inflammatory and antibacterial effects in reducing drug loading on woman organism and without its allergization.

EFFECT: improved method for prophylaxis.

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Description

The invention relates to medicine, in particular to obstetrics.

One of the most common operations performed in an obstetric clinic is cesarean section. In Russia, the frequency of this operation in 2000 was 14.3%, in Moscow 16%. Due to the increase in the frequency of operations, the frequency of various postoperative complications also increases, reaching an average of 20-30%, among which endometritis and wound infection are most common. At the same time, endometritis accounts for up to 30-60% of all infectious complications [1, 2].

A known method for the prevention of purulent-inflammatory complications after abdominal delivery, including the appointment of antibacterial drugs [1].

The disadvantage of this method of preventing inflammatory complications after abdominal delivery is not always the sufficient effectiveness of the prescribed drugs, as well as their toxic effect on the liver, kidneys (up to 14%), gastrointestinal tract, individual intolerance (10%), the appearance of resistant strains of microorganisms [2, 3, 4].

The objective of the invention is a method for the prevention of inflammatory complications in puerperas after cesarean section, which has greater effectiveness and less side effects (complications from internal organs: liver, kidneys, gastrointestinal tract, etc.).

The problem is solved by the method consisting in the fact that a daily session of intravenous ozone therapy is carried out daily for 5-6 days while taking Wobenzym 3 days before surgery and 5-6 days after surgery.

The practical method is as follows. Wobenzym is prescribed 4-5 tablets 3 times a day, 400 ml of ozonized physiological solution (3-3.5 mg of ozone in 1000 ml of physiological solution) is administered intravenously 1 time per day. For the preparation of ozonized physiological saline, an ozonizer installation of the company "Medozon" (Russia) was used.

The method allows you to activate redox and detoxification processes, the immune system, to have pronounced anti-inflammatory and antibacterial effects, which favorably affects the course of the postoperative period.

Example 1. Pregnant M.I.V., 39 years old. The history of the disease №2255 (2002).

Obstetric diagnosis: Pregnancy 38-39 weeks. Head presentation. Dropsy of pregnant women. Uterine fibroids. Chronic pyelonephritis. Birthright at 39. 2-fold entanglement of the umbilical cord around the neck of the fetus (according to ultrasound). Narrow basin. Indications for surgery: Birthright at 39. Anatomical features of the pelvis (narrowing the size of the wide part, flattening of the sacrum). The complicated course of this pregnancy (fetoplacental insufficiency at 26 weeks). Estimated fetal mass according to ultrasound data 3600 g.

History of 1st pregnancy given. In 1995, a polypectomy of the cervical canal, endometriosis (treatment).

Considering the burdened obstetric and gynecological history, I received 5 tablets 3 times a day for wobenzyme before surgery for 3 days; after 5 days of abdominal delivery I received 5 tablets 3 times a day and received 400 ml of ozonized physiological saline (3- 3.5 mg / l) for 20 minutes 6 hours after surgery. Then, at 2, 3, 4, 5, day, once a day, intravenously in the above concentration. Antibacterial drugs were not prescribed.

After preventive treatment, the body temperature is 36.6 degrees Celsius. Clinical blood test: white blood cells - 4.8 × 10 ⁹ / l, red blood cells - 3.8 × 10 ¹² / l, hemoglobin - 119 g / l, ESR - 22 mm / h. Ultrasound of the uterus is closed. Seam area without features.

Example 2. Pregnant K.S.A., 30 years old. Medical history N 2343 (2001). Obstetric diagnosis: Pregnancy 38-39 weeks. Head presentation. IVF and PE (5th attempt). Birthright in 30 years. Infertility I. Arterial hypotension.

History: 1 pregnancy - this, cervical erosion, chronic adnexitis, infertility I, 1995 - laparoscopy (biopsy of the right ovary, endometriosis of the cervical canal (coagulation of foci of endometriosis)).

Indications for surgery: IVF and PE.

Before the operation, Caesarean section received Wobenzym for 3 days, 5 tablets 3 times a day. A cesarean section was performed, in the postoperative period, for 5 days, I received 5 tablets of Wobenzym 3 times a day and 400 ml of ozonized physiological saline solution (3-3.5 mg / l) was administered for 20 minutes 1 time per day, also for 5 days. Antibacterial drugs were not prescribed.

After preventive treatment, the body temperature is 36.6 degrees Celsius. Clinical blood test: white blood cells - 7.8x10 ⁹ / l, red blood cells - 3.9 × 10 ¹² / l, hemoglobin - 120 g / l, ESR - 13 mm / h.

Example 3. Pregnant Sh.T.L., 23 years old. No. of medical history 2304 (2001). Obstetric diagnosis: Pregnancy 38 weeks. Head presentation. Condition after rupture of the retina and laser coagulation in January 11, Indications for surgery: the onset of labor. A burdened somatic history.

History 1 - this pregnancy.

Before the operation, I received 5 tablets 3 times a day for 3 days. A cesarean section was performed, in the postoperative period, for 5 days, I received 5 tablets of Wobenzym 3 times a day and 400 ml of ozonized physiological saline solution (3-3.5 mg / l) was administered for 20 minutes 1 time per day, also for 5 days. Antibacterial drugs were not prescribed.

After preventive treatment, the body temperature is 36.6 degrees Celsius. Clinical blood test: white blood cells - 7.9 × 10 ⁹ / l, red blood cells - 3.6 × 10 ¹² / l, hemoglobin - 114 g / l, ESR - 21 mm / h.

All patients in this group had a history of complicated pregnancy, a burden of obstetric and gynecological and somatic history.

Prophylactic treatment of 50 patients before and after cesarean section to avoid postoperative inflammatory complications. After ozone therapy, all patients noted good health, the absence of pain in the lower abdomen in the postoperative period, the possibility of early breastfeeding, and normal body temperature.

Complications and allergic reactions were not observed in any patient.

Sources of information

1. Akhmatova Z.M., Voropaeva S.D. Ways to reduce complications after cesarean section. Q. Ohr mat. - 1988 - No. 12, p. 35-39.

2. Gurtovoi B. L., Voropaeva S. D., Emelyanova A. I., Sokolova I. E. Etiology and antibacterial therapy of postpartum endometritis in modern conditions. Akush and gin., 1988, No. 4, p. 47.

3. Gurtovoi B. L., Kulakov V. I., Voropaev S. D. The use of antibiotics in obstetrics and gynecology. The library is practical. a doctor. Actual issues Akush and gin. 1996, p. 140.

4. Davydov A.I. Purulent-septic complications of caesarean section. Prevention, diagnosis, treatment. New technologies in Akush and Gin. 1997, p. 13-18.

Claims (1)

A method for the prevention of purulent-septic complications in puerperas after cesarean section, which consists in the fact that daily after surgery for 5-6 days, a session of intravenous ozone therapy is carried out while taking wobenzym 3 days before the operation and 5-6 days after the operation.