New Treatment Approaches to Prevent Premature Rupture of Membranes in Pregnant Women With Varicose Disease

DergiPark: 420842tmsjAims: To investigate modern methods to prevent premature rupture of membranes by the use of chlorhexidine inpregnant women with varicose disease.Methods: The data of 39 pregnant women with varicose disease, who delivered between 2014 and 2016 at MaternityHospital No. 3, Zaporozhye were analyzed using SPSS software. Patients were divided in 3 groups according totheir medical history, complications during pregnancy, childbirth and postpartum period. The 1st group consistedof 13 pregnant women who did not receive prenatal vaginal douching with chlorhexidine; the 2nd group consistedof 13 patients with varicose disease, who received douching of birth canal with vaginal suppositories with chlorhexidine1 time per day for 10 days before their delivery, but did not undergo a rehabilitation at the sanatorium; and the3rd group had 13 pregnant women who received sanatorium rehabilitation at ‘‘Veliki lug’’ during the II. trimester oftheir pregnancy with the course of 1 chlorhexidine suppository per day for 10 days before delivery.Results:In the 1st group, the percentage of premature death was 61.5%; anemia and significant ultrasound markerswere present in 46.2%; the percentage for the presence of hematometra was 38.5%; premature rupture of membranes,anomalies of labor and polyhydroamniosis were 30.8%; chorioamnionitis 15.4%; and intrauterine infection offetus was 7.7%. In the 2nd group, anemia was present in 35%, 23.1% showed anomalies of labor; premature ruptureof membranes, ultrasound markers, premature death, and hematometra were present in 15.4%. Whereas in the 3rdgroup, anemia and anomalies of labor were present in 15.4%, premature rupture of the membranes and prematuredeath were present in 7.7% of the patients.Conclusion: With its broad antibacterial and antiviral effect, chlorhexidine in antiseptic form was found to bebeneficial and it is found to promote the restoration of the vaginal microflora

The Importance of Individual Clinical and Laboratory Indicators in the Differential Diagnosis of Postpartum Septic Complications

DergiPark: 439373tmsjAims: To perform a comparative analysis of individual clinical and laboratory indicators in the differential diagnosis of conditionally limited and generalized forms of postpartum septic complications.Methods: The study included 34 patients at Gynecology Department of the Zaporizhzhia Regional Clinical Hospital from 2013 to 2016 with postpartum purulent-septic diseases. Patients were divided into 2 groups. Group I consisted of 15 women who were diagnosed with a conditionally limited postpartum purulent-inflammatory disease (endometritis). Group II included 19 women with generalized forms of postpartum purulent-inflammatory diseases (peritonitis, sepsis). For the diagnosis of Multiple Organ Failure due to sepsis, we used the Sequential (Sepsis-Related) Organ Failure Assessment and quick Sequential (Sepsis-Related) Organ Failure Assessment. The differences between the first and second group were assessed by using the Mann-Whitney U test and STATISTICA Version 10. Results: Body temperature was increased in all 34 patients. The average heart rate in group I was 91.6 ± 8.35 beats/ min and 102.26 ± 16.42 beats/min in group II. The average respiratory rate was 19.07 ± 2.49 breaths/min in group I and 24.16 ± 5.09 breaths/min in group II. In group I, none of the patients scored a total of two or more points on the Sequential (Sepsis-Related) Organ Failure Assessment and quick Sequential (Sepsis-Related) Organ Failure Assessment scales; in group II, there were 5 (26.32%) patients who had scored two points or more on the Sequential (Sepsis-Related) Organ Failure Assessment scale; and 2 (10.53%) patients had scored 2 points or more in the quick Sequential (Sepsis-Related) Organ Failure Assessment scale. Conclusion: Clinical cases of postpartum period with inflammation of uterus and signs of multiple organ failure should be; regarded as a septic state, assessed by the Sequential (Sepsis-Related) Organ Failure Assessment scale as they require urgent medical help

Resultados del tratamiento del ictus isquémico con y sin administración de terapia trombolítica: un estudio comparativo.

Introduction: Intravenous thrombolytic therapy at the cerebral circulation within the first 3 hours of ischemic stroke onset offers substantial net benefits for virtually all patients with potentially disabling deficits. Aim: Evaluate the course of the disease in patients with ischemic stroke with a clinical improvement of the neurological deficit during the 3-hour window period in the groups of patients who received and did not receive intravenous thrombolysis. Methods: A descriptive, retrospective study was performed, in which we reviewed demographical, clinical, tomographical, procedural records of the patients at 6th Municipal Clinical Hospital, Zaporozhye from 2010-2017. A total of 78 case histories were analyzed, 12 were patients with Intravenous thrombolytic therapy and 66 with traditional therapy. The results of the treatment were assessed on the basis of NIHSS scale and the Modified Rankin scale after 90 days after treatment. The statistical data was processed using STATISTICA® 7.0. Results: In the group of patients with Intravenous thrombolytic therapy, none of the patients showed clinical worsening. In the 2nd group, 21 patients showed an increase in neurologic deficit in the first 3-5 days after hospitalization. The NIHSS score in the 1stgroup, when deciding on Intravenous thrombolytic therapy and at discharge for 20 days, was 6 ±3,8 and 0,5 ±0,2, respectively. In the 2nd group; 6 ±2,9 and 4 ±1,11. According to the modified Rankine scale, after 3 months in the first group, the index was 0,5 ±0,1 (≤ 1 in 8 patients); in the second group 1 ±0,3. Conclusions: Intravenous thrombolysis in patients with spontaneous early regression of neurological deficits is advisable, and failure is not justified.Introducción: La terapia trombolítica intravenosa en la circulación cerebral, dentro de las primeras 3 horas del accidente cerebrovascular isquémico ofrece importantes beneficios netos para prácticamente todos los pacientes con déficit potencialmente incapacitantes. Objetivo: Evaluar el curso de la enfermedad en pacientes con accidente cerebrovascular isquémico con una mejoría clínica del déficit neurológico durante el período de ventana de 3 horas en los grupos de pacientes que recibieron y no recibieron trombólisis intravenosa. Métodos: Se realizó un estudio descriptivo, retrospectivo, donde revisamos los registros demográficos, clínicos, tomográficos, de procedimiento de los pacientes en el 6° Hospital Clínico Municipal, Zaporozhye desde 2010-2017. Se analizaron un total de 78 historias clínicas, 12 eran pacientes con terapia trombolítica intravenosa y 66 con terapia tradicional. Los resultados del tratamiento se evaluaron sobre la base de la escala NIHSS y la escala de Rankin modificada después de 90 días después del tratamiento. Los datos se procesaron utilizando estadístico STATISTICA 7.0. Resultados: En el grupo de pacientes con terapia trombolítica intravenosa, ninguno de los pacientes presentó un empeoramiento clínico. En el segundo grupo, 21 pacientes mostraron un aumento en el déficit neurológico en los primeros 3-5 días después de la hospitalización. La puntuación de NIHSS en el 1er grupo, cuando se decidió sobre terapia trombolítica intravenosa y al alta durante 20 días, fue de 6±3,8 y 0,5±0,2, respectivamente. En el segundo grupo; 6±2,9 y 4±1,11. De acuerdo con la escala de Rankine modificada, después de 3 meses en el primer grupo, el índice fue de 0,5±0,1 (≤ 1 en 8 pacientes); en el segundo grupo 1±0,3. Conclusiones: La trombólisis intravenosa en pacientes con regresión temprana espontánea de déficits neurológicos es aconsejable, y el fracaso no está justificado