Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Research Article Volume 2 Issue 10

A Prognostic Tool to Predict the Development of Postpartum Endometritis and Haematometra

Bulavenko O1, Ostapiuk Lesia1,2*, Rud V1 and Rud O3

1Department of Obstetrics and Gynaecology, Vinnytsia National Medical University of the Ministry of Health of Ukraine, Ukraine
2Lviv Regional Public Health Center, Lviv, Ukraine
3Country Clinical Operations, Roche Products Limited, Welwyn Garden City, United Kingdom

*Corresponding Author: Ostapiuk Lesia, Vinnytsia National Medical University of the Ministry of Health of Ukraine, Lviv Regional Public Health Center, Lviv, Ukraine.

Received: September 03, 2020; Published: September 28, 2020

×

Abstract

Introduction: Obstetric sepsis remains one of the top 5 causes of maternal death in Ukraine, according to the data collected between 2009 - 2015. Postpartum purulent-inflammatory diseases are the reason of sepsis occurrence. Currently, there is a lack of methods of early diagnostics of postpartum endometritis (PPE).

Objectives: The main aim is to evaluate the risks of postpartum endometritis (PPE) among postpartum women and development of means of its early diagnosis using fluorescent spectroscopy. In addition, the reliability of such approach is tested via creation of a prognostic model.

Methods: Fluorescent spectroscopy was used, along with the standard diagnostic tools in order to diagnose 170 postpartum patients of the participants cohort and 40 postpartum patients of the control group with uncomplicated course of postpartum period.

Results: By statistical analysis using logistic regression, the data was evaluated according to more than 40 indicators and as a result, a prognostic model was derived. This prognostic model enables to assess the probability of development of postpartum endometritis among postpartum patients. ROC-analysis was implied in order to evaluate the quality of the proposed model.

Conclusion: Proposed multi-structured model for prognosis of the development of PPE among postpartum women, which enables determination of the patient groups susceptible to develop PPE. The major risk factors in the finalised multi-structured model of the development of PPE are: extragenital pathology, risk of miscarriage, TORCH-infections, colpitis, labour duration > 12 hrs, abnormal labour, lambda (λ) max, fluorescence intensity ≤ 0,845, a number of bed days and the presence of foetal distress.

It was confirmed, that the results obtained by using fluorescent spectroscopy have the highest significance among the prognostic tools used in the investigation. Therefore, application of this prognostic tool in clinical practice is a highly feasible way to improve diagnosis and prognosis of the development of postpartum endometritis.

Keywords: Postpartum Endometritis; Fluorescent Spectroscopy; Prognostic Model; Haematometra; ROC-Analysis

×

References

  1. Sniehirov PH. “Safety of pregnant women: a multidisciplinary approach”. Ukrainian Medical Journal120 7-8.
  2. Smaill FM., еt al. “Antibiotic prophylaxis versus no prophylaxis for preventing infection after caesarean section”. The Cochrane Database of Systematic Reviews 10 (2014): CD007482.
  3. Kukuruza IL., еt al. “Analysis of maternal mortality from sepsis in Vinnytsia region. Ways to improve diagnosis and treatment from the standpoint of evidence-based medicine”. Emergency Medicine 3 (2017).
  4. Dillen Jvan., еt al. “Maternal sepsis: epidemiology, etiology and outcome”. Current Opinion in Infectious Diseases 3 (2010): 249-254.
  5. Acosta CD. “Sepsis and maternal mortality”. Current Opinion in Obstetrics and Gynecology 2 (2013): 109-116.
  6. Baev OR., еt al. “Antimicrobial prevention of complications after caesarean section”. Questions of Gynecology, Obstetrics and Perinatology4 (2011): 85-89.
  7. Boichuk AV. “Mixed infection in obstetrics and gynecology and modern approaches to treatment”. Emergency Medicine69 (2015): 92-95.
  8. Vdovychenko YuP., еt al. “Rational antibiotic prophylaxis of infectious and inflammatory complications after intrauterine operations”. Women's Health79: 160-163.
  9. Herych ID., et al. “Method of early diagnosis of purulent-septic complications using the method of fluorescence spectroscopy”. Pat. №76953 Ukraina A61V 17/00 G01N 33/48, G01N 21/64 (2013). № 201207441: 2.
  10. Bulavenko OV., et al. “Method of early diagnosis of postpartum purulent-septic complications using the method of fluorescence spectroscopy”. Pat. №133472 Ukraine G01N 33/48 G01N 21/64 (2019). № 10669 (2018): 7.
  11. Hryhoriev SH., еt al. “The role and place of logistic regression and ROC-analysis in solving medical diagnostic problems”. Journal of Infectious Diseases4 (2016): 36-45.
  12. Bulavenko O., еt al. “Logistic Regression as a Prognostic Tool for Estimating Development of Postpartum Endometritis and Lactostasis”. Acta Scientific Women's Health7 (2019): 02-05.
  13. Bulavenko O., еt al. “Prognostic Model of Postpartum Endometritis Development”. EC Gynaecology2 (2020): 01-07.
  14. Shypunov АB., еt al. “Visual statistics”. R. М.: DMK Press (2014): 298.
  15. McDonald JH. “Handbook of Biological Statistics”. 3rd Sparky House Publishing, Baltimore, Maryland (2014).
  16. Mangiafico SS. “An R Companion for the Handbook of Biological Statistics”. Version 1.3.2 (2015).
×

Citation

Citation: Ostapiuk Lesia., et al. “A Prognostic Tool to Predict the Development of Postpartum Endometritis and Haematometra". Acta Scientific Women's Health 2.10 (2020): 18-23.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
Impact Factor0.539

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 20, 2021.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US