ACUTE LACTATION MASTITIS: CURRENT STATE OF THE PROBLEM (literature review)

Acute lactation mastitis is a formidable complication of the postpartum period. The development of the disease is influenced by two leading factors - lactostasis and microbial factor. The presence of unresolved lactostasis increases the likelihood of developing acute mastitis. The main causative agent of acute lactation mastitis is Staphylococcus aureus, which, according to a number of authors, is isolated in monoculture in 91%, and in association with other microflora - in 2.5% of observations. There are 2 forms (serous, infiltrative) of non-purulent mastitis and 3 forms (abscessing, phlegmonous and gangrenous) of purulent mastitis. Expressed local and general symptoms of purulent inflammation of the mammary gland allow in most cases to make the correct diagnosis. Among the instrumental methods for diagnosing acute lactation mastitis, the main role belongs to ultrasound of the mammary glands. Diagnostic aspiration biopsy is performed according to indications and allows to identify the first signs of suppuration, the presence of purulent foci. The main condition for successful therapy of acute lactational mastitis is to eliminate lactostasis as effectively and as quickly as possible. Timely complex therapy of the initial stages of acute mastitis (serous, infiltrative) helps to prevent the development of the suppurative process. Conservative treatment of acute lactational mastitis includes the use of antibacterial drugs, analgesics, desensitizing and immunomodulatory agents. In acute purulent mastitis, surgical treatment is mainly carried out with necrectomy, sanitation of the purulent focus and drainage. Minimally invasive methods of treating acute purulent mastitis have an advantage due to minimal trauma and optimal aesthetic effect. Prevention of lactational mastitis consists of following the rules of breastfeeding and preventing the development of lactostasis.