ДЕЯКІ АСПЕКТИ ПРОГНОЗУВАННЯ ПІСЛЯПОЛОГОВИХ СЕПТИЧНИХ УСКЛАДНЕНЬ У ВАГІТНИХ ГРУПИ РИЗИКУ

Postpartum purulent-septic complications remain an urgent problem of modern obstetrics. The development of these complications is due to certain features that occur in a woman's body during pregnancy, as well as changes in the fetoplacental complex that occur in the early stages of pregnancy and lead to the formation of placental dysfunction. Among them, the leading importance belongs to placental dysfunction, which is a frequent complication of pregnancy (from 14 to 22 %), accompanied by hypoxia, delayed intrauterine development of the fetus and is one of the most frequent causes of perinatal morbidity (up to 60 %) and mortality, as well as one of the risk factors for the development of postpartum complications. The aim of our study was to investigate the risk factors for the occurrence of postpartum septic complications in pregnant women at risk. During the research, we examined and analyzed the course of pregnancy in 25 women from the risk group for the development of purulent-septic postpartum complications. The main group (25 women), pregnant women who had clinical signs of placental dysfunction in the early stages of gestation. The control group consisted of 25 healthy pregnant women, without manifestations of placental insufficiency during the course of pregnancy, whose clinical and paraclinical indicators served as a control for comparing the data of the paraclinical examination of pregnant women relative to the main group. It should be noted that in the main group, the age of women over 30 years old occurs in 28.4 % of cases, compared to 12 % of pregnant women in the control group (p<0.05), which is consistent with data, which note a higher probability of developing placental dysfunction and pregnancy complications in older pregnant women. As some authors note, placental insufficiency also occurs more often in young pregnant women. It should be noted that pregnant women with placental dysfunction more often (p<0.05) suffered from infectious diseases, such as acute respiratory viral infection, diseases of the respiratory tract (pneumonia, bronchitis), as well as diseases of the gastrointestinal tract. The latter suggests that infection plays a role in the genesis of this pregnancy complication. In the presence of placental dysfunction in pregnant women, a fairly high frequency of pregnancy complications was noted in the anamnesis. When analyzing the results of the histological examination of placentas from mothers of the risk group, the following results were obtained. A pattern of deciduitis was determined, in the stroma of the placental villi, longitudinally oriented channels were identified, in which Kashchenko-Hofbauer cells were located. Scattered foci of necrosis and sclerosis of the villi were determined. Our research showed that pregnant women with signs of placental dysfunction during pregnancy should be included in the risk group for the development of postpartum septic complications.