[Current diagnostic methods and therapeutic principles in various forms of puerperal endometritis]

A total of 55 puerperants+ with endometritis followed by spontaneous labours (26 females) and cesarean operation (29 females) were studied. A comprehensive study involved echography, hysteroscopy, bacteriological analysis of the uterine content, and histological examination of mucosal curettage of the corpus uteri. Three types of the clinical course of endometritis were identified: 1) in the presence of placental tissue residues; 2) with necrosis of delayed decidual tissue and lochia- or hematometra; and 3) a "pure" type of endometritis without abnormal tissues in the uterus. Uterine curettage was performed in the first type of endometritis, vacuum aspiration of its content was carried out in Type 2. The patients from Group 3 who had the most severe inflammatory process of the uterus underwent its cavity washing with large volumes of cold antiseptic solutions, took detoxifying, ++rheo-vasoactive and protein agents, received immunomodulating and uterotonic therapy. The algorithm developed for management of puerperants+ with postpartum endometritis substantially enhanced the efficiency of therapy and prevented severe septic events in time.