Purulent-septic infections in puerperas. Part 1. Рrevalence, risk factors, epidemiological surveillance (literature review)

Abstract

Purulent-septic infections (PSI) of puerperas are one of the leading medical and social problems of modern health care. A significant prevalence, an upward trend, insufficient completeness of their identification and registration, along with a high degree of obstetric aggression — these are the modern features of this group of infections. To study the prevalence of PSI in the postpartum period (sepsis, peritonitis, endometritis, mastitis, and surgical site infections), identify risk factors, and assess the effectiveness of epidemiological surveillance of these infections, the analysis of publications on this topic has been carried out on several information resources: ELibrary, Google Scholar, PubMed, NCBI. Postpartum endometritis was found to be the most common form of PSI in puerperas, accounting for 3 to 20% PSI cases, and up to 40.0-54.3% among patients with postpartum inflammatory complications. Surgical intervention is one of the leading risk factors for the development of PSI after childbirth. For example, a cesarean section increases the risk of PSI by 5-20%. The systems of epidemiological surveillance for PSI of puerperas in different countries differ in the approach both to identifying, recording and registering cases, and to collecting information about the place and time of their highest risk. PSI of puerperas is a dynamically changing interdisciplinary problem at the intersection of obstetrics, gynecology and epidemiology. Despite the data on the prevalence of certain nosologies and their risk factors, there are a number of issues that can be discussed and need to be addressed.