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Introduction: Postpartum endometritis is a prevalent reproductive disorder in bovines, leading to a prolonged open period, infertility, and other complications. While Lactobacillus strains can mitigate these conditions by reducing uterine inflammation, their effectiveness is limited due to a lack of direct anti microbial action and extended treatment duration. This study aimed to construct a recombinant Lactobacillus johnsonii strain expressing bovine Granulocytemacrophage colony-stimulating factor (GM-CSF) to evaluate its potential in reducing postpartum uterine inflammation. Methods: The recombinant Lactobacillus johnsonii strain was engineered to express bovine GM-CSF and administered to pregnant mice via vaginal perfusion. Postpartum endometritis was induced using E. coli infection, and the protective effects of the engineered strain were assessed. Inflammatory markers (IL-6, IL-1β, TNF-α), myeloperoxidase (MPO) activity, and nitric oxide (NO) concentration were measured. Histological examination was performed to evaluate uterine morphology and pathological damage. Results: The recombinant L. johnsonii strain expressing GM-CSF significantly reduced inflammation levels induced by E. coli infection in the uterus. This reduction was evidenced by decreased expression of IL-6, IL-1β, TNF-α, as well as reduced MPO activity and NO concentration. Histological examination revealed improved uterine morphology and reduced pathological damage in mice treated with the recombinant GM-CSF strain. Crucially, the recombinant strain also exerts beneficial effects on bovine endometritis by reducing levels of inflammatory cytokines, suggesting a beneficial effect on clinical bovine endometritis. Conclusion: The recombinant Lactobacillus johnsonii expressing GM-CSF demonstrated protective effects against postpartum endometritis in bovines by reducing inflammatory cytokines. The findings indicate the potential clinical application of this engineered strain in preventing postpartum uterine inflammation, offering a novel and effective protective option for related disorders and improving bovine reproductive efficiency. [ABSTRACT FROM AUTHOR]

Sura Markos,1 Surafel Nadew Firdawoke,2 Eshetu Dabaro Gagamo,2 Mintesnot Zemedkun Workeneh2 1Department of Internal Medicine, Division of Cardiology, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Internal Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, EthiopiaCorrespondence: Sura Markos, Tel +251-910878529, Email surmark430@gmail.comAbstract: Rarely observed during pregnancy and the postpartum period, right side infective endocarditis (IE) is particularly uncommon among non-drug-addicted individuals. Nonetheless, if it does occur, it poses significant health risks for both the mother and the fetus, even in the absence of pre-existing heart diseases. This case report describes a rare presentation of right-sided IE (IE) in a 40-year-old woman from rural Ethiopia with postpartum endometritis. The patient presented with atypical symptoms, making it challenging to identify the underlying cause. Through careful diagnostic evaluation and a multidisciplinary approach, the team successfully diagnosed and treated the patient, highlighting the importance of swift and accurate diagnosis for managing uncommon right-sided IE cases.Keywords: postpartum, right-side endocarditis, postpartum endometritis

Background. Suppurative septic postpartum complications occupy a leading position in the structure of causes of maternal mortality. Information about the characteristics of pathogenic microflora in various forms of complications and analysis of its resistance to antibacterial drugs determine the choice of rational therapy for this pathology.Objectives — to characterize the isolated pathogenic microflora in obstetric patients with suppurative septic postpartum complications.Methods. A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology No. 2 of the Omsk State Medical University and the Department of Gynecology of the Omsk Regional Clinical Hospital. The study included 123 cesarean section patients treated from January 2013 to December 2022 who were divided into three groups: Group A — uncomplicated course of postpartum endometritis, n = 55; Group B — complicated forms of postpartum endometritis, n = 48: B1 — local complications (suture failure following cesarean section; parametritis) n = 29; B2 — pelvic peritonitis, n = 19; Group C — septic complications following critical obstetric conditions, n = 20. The pathogenic microflora of uterine and abdominal cavities was examined; the extent of contamination with a pathogen and sensitivity to antibacterial drugs were determined. The isolated microorganisms were identified using a MicroTax bacteriological analyzer (Austria), Vitek2 Compact (France) and routine methods; a disk diffusion method was employed to determine the sensitivity of microorganisms to antibacterial drugs. Calculations were performed using licensed Microsoft Office Excel 2013 and Statistica 10 programs (StatSoft Inc., USA). Nonparametric nominal data were compared using Pearson’s chi-squared test with p-value determination.Results. The pathogenic microflora was dominated by S. epidermidis, E. faecalis, E. coli, and E. faecium. In 2018–2022, a statistically significant decrease was observed in the isolation rate of S. epidermidis (p = 0.016), E. faecalis (p < 0.001), and E. faecium (p = 0.05). The highest resistance was exhibited by bacteria to the following antibiotics: S. epidermidis — cephalosporins (30.16%); E. faecalis — fluoroquinolones (33.33%); E. coli — cephalosporins (65.91%) and β-lactamase-resistant penicillins (40.91%); E. faecium — aminopenicillins (64.10%) and fluoroquinolones (50.0%); А. baumannii — fluoroquinolones, cephalosporins, carbapenems (100%), and aminoglycosides (84.2%). A contamination assessment revealed a high titer of isolated microorganisms in 60.53% of cases. We found a statistically significantly higher isolation rate of S. еpidermidis (p < 0.001), E. faecium (p = 0.01), and A. baumannii (p = 0.02) in the setting of pelvic peritonitis as compared to uncomplicated endometritis. In the case of suppurative septic complications due to critical obstetric conditions, the isolation rate was higher for S. еpidermidis (p

Background and Objectives: Triclosan-coated sutures (antibacterial sutures) can reduce the risk of postoperative surgical site infection. This study aimed to investigate the effect of intraoperative factors, including antibacterial sutures, on the risk of postpartum septic complications. Materials and Methods: The prospective study included patients who underwent caesarean section. The exclusion criterion was chorioamnionitis. The investigation group patient's (n = 67) uterus and fascial sheath of the abdominal wall were sutured with triclosan-coated polyglactin 910 sutures during surgery. The control group consisted of 98 patients using uncoated polyglactin 910 sutures only. The patients were contacted by phone after the 30th postoperative day. Results: No significant difference was found between the investigation group and the control group in the development of postpartum endometritis (11.7% in the investigation group vs. 8.4% in the control group, p = 0.401), wound infection (6.3% vs. 3.6%, p = 0.444) or patients experienced any septic complication (15.9% vs. 12%, p = 0.506). Postpartum endometritis was more common in patients who underwent instrumental uterine examination during the surgery (23.8% vs. 18%, p = 0.043). A moderately strong correlation was found for haemoglobin level on the third–fourth postoperative day with the development of postpartum septic complications, p < 0.001, Pearson coefficient −0.319. Post-caesarean delivery septic complications were not statistically more common in patients with blood loss greater than 1 L. The incidence of post-caesarean endometritis was 13.4%, and wound infection was 4.8% in this study's hospital, having five to six thousand deliveries per year. Conclusions: Using antibacterial sutures during caesarean section does not affect the incidence of postpartum septic complications. Instrumental uterine examination during caesarean section increases the risk of post-caesarean endometritis and is, therefore, not recommended. Haemoglobin level on the 3rd–4th postoperative day, rather than the estimated blood loss during surgery, affects the development of postpartum septic complications. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the impact of different maternal Body Mass Index (BMI) classes on the risk of postpartum endometritis, wound infection, and breast abscess after different modes of delivery. Secondly to estimate how the risk of postpartum infection varies with different maternal BMI groups after induction of labor and after obstetric anal sphincter injuries. A population-based observational study including women who gave birth during eight years (N = 841,780). Data were collected from three Swedish Medical Health Registers, the Swedish Medical Birth Register, the Swedish National Patient Register, and the Swedish Prescribed Drug Register. Outcomes were defined by ICD-10 codes given within eight weeks postpartum. The reference population was uninfected women. Odds ratios were determined using Mantel–Haenszel technique. Year of delivery, maternal age, parity and smoking in early pregnancy were considered as confounders. There was a dose-dependent relationship between an increasing maternal BMI and a higher risk for postpartum infections. Women in obesity class II and III had an increased risk for endometritis after normal vaginal delivery aOR 1.45 (95% CI: 1.29–1.63) and for wound infections after cesarean section aOR 3.83 (95% CI: 3.39–4.32). There was no difference in how maternal BMI affected the association between cesarean section and wound infection, regardless of whether it was planned or emergent. Women in obesity class II and III had a lower risk of breast abscess compared with normal-weight women, aOR 0.47 (95% CI: 0.38–0.58). The risk of endometritis after labor induction decreased with increasing maternal BMI. The risk of wound infection among women with an obstetrical sphincter injury decreased with increasing BMI. This study provides new knowledge about the impact of maternal BMI on the risk of postpartum infections after different modes of delivery. There was no difference in how BMI affected the association between cesarean section and wound infections, regardless of whether it was a planned cesarean section or an emergency cesarean section. [ABSTRACT FROM AUTHOR]

Introduction: Uterine prolapse in pregnancy is an uncommon occurrence that can lead to a wide spectrum of complications. Postpartum Group A Streptococcus (GAS) endometritis is a rare but life-threatening condition. Our aim was to review the literature regarding management of prolapse in pregnancy and maternal infection as a rare complication. Methods and results: We present a case of uterine prolapse with cervical elongation presenting in the third trimester. The patient's prolapse was refractory to pessary management. She was induced at 36 weeks due to an abnormal fetal heart tracing and had an uncomplicated vaginal delivery. Her postpartum course was complicated by GAS endometritis and septic shock. She recovered after antibiotic therapy and her prolapse did not recur postpartum. Conclusion: Prolapse during pregnancy carries a risk of several complications but does not preclude a vaginal delivery. Management must be patient-centered and individualized. GAS sepsis is a potential, rare, and life-threatening postpartum complication requiring swift identification and treatment. [ABSTRACT FROM AUTHOR]

Clinical postpartum endometritis due to bacterial invasion is one of the most common diseases affecting dairy cows in postpartum period; antibiotics are widely utilized as a treatment to overcome this affection. Recently, bacterial resistance to antibiotics due to uncontrolled usage became one of the most serious problems facing the medical community, so, the aim of study was to detect the effectiveness of nano-silver particles as a treatment for postpartum endometritis in dairy Holstein cows. At 35-40 days postpartum, twenty one Holstein cows were diagnosed to be affected with postpartum endometritis, depending on clinical and ultrasonography examination. The treatment protocol included intrauterine infusion with 50 ml of silver nanoparticles solution (50 ppm/ml) for five consecutive days, and single dose of PGF-2α analogue as a treatment for animals with a corpus lutetum on their ovaries. At the 7th day post-treatment, serum level tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) and serum amyloid-A (SAA) and was significantly decreased (P<0.01). Also, the level of ceruloplasmin and haptoglobin (Hp) in serum recorded a significant decrement(P<0.05) upon treatment with silver nanoparticles.In addition, uterine secretions were found with a significant decrease or disappeared completely, and endometrial thickness decrement was detected upon ultrasonography examination. At re-examination (49-54 days postpartum), 14 animals out of 21 animals (66.6%) were recovered successfully from endometritis. The pregnancy rate on 40th day post-service was 71.4 % (10 out of 14 animals were found pregnant after insemination on their observed estrus). As a conclusion, this study proved the efficacy of silver nanoparticles as a treatment for postpartum endometritis in dairy Holstein cows. So, it could substitute antibiotic treatment in such cases to avoid the antibiotic resistance problems. [ABSTRACT FROM AUTHOR]

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 40.054.3% 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 520%. 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.

Background and Objectives: Triclosan-coated sutures (antibacterial sutures) can reduce the risk of postoperative surgical site infection. This study aimed to investigate the effect of intraoperative factors, including antibacterial sutures, on the risk of postpartum septic complications. Materials and Methods: The prospective study included patients who underwent caesarean section. The exclusion criterion was chorioamnionitis. The investigation group patient’s (n = 67) uterus and fascial sheath of the abdominal wall were sutured with triclosan-coated polyglactin 910 sutures during surgery. The control group consisted of 98 patients using uncoated polyglactin 910 sutures only. The patients were contacted by phone after the 30th postoperative day. Results: No significant difference was found between the investigation group and the control group in the development of postpartum endometritis (11.7% in the investigation group vs. 8.4% in the control group, p = 0.401), wound infection (6.3% vs. 3.6%, p = 0.444) or patients experienced any septic complication (15.9% vs. 12%, p = 0.506). Postpartum endometritis was more common in patients who underwent instrumental uterine examination during the surgery (23.8% vs. 18%, p = 0.043). A moderately strong correlation was found for haemoglobin level on the third–fourth postoperative day with the development of postpartum septic complications, p < 0.001, Pearson coefficient −0.319. Post-caesarean delivery septic complications were not statistically more common in patients with blood loss greater than 1 L. The incidence of post-caesarean endometritis was 13.4%, and wound infection was 4.8% in this study’s hospital, having five to six thousand deliveries per year. Conclusions: Using antibacterial sutures during caesarean section does not affect the incidence of postpartum septic complications. Instrumental uterine examination during caesarean section increases the risk of post-caesarean endometritis and is, therefore, not recommended. Haemoglobin level on the 3rd–4th postoperative day, rather than the estimated blood loss during surgery, affects the development of postpartum septic complications.

This article provides a review of peripartum infections, including intra-amniotic infection, postpartum endometritis, and postabortal infections. We present a case of postabortal infection to frame the review. The microbiology, pathogenesis, risk factors, diagnosis, and treatment of peripartum infections are reviewed, and a critical appraisal of the literature and available guidelines is provided. There is a focus on discussing optimal antimicrobial therapy for treating these infections. [ABSTRACT FROM AUTHOR]

Postpartum endometritis is one of the most widespread pathologies in animal husbandry. They often occur on the background of exposure on animals stress factors, microclimate disorders, complete feeding, which is accompanied by decrease of the resistance, leads to increasing morbidity, etc. The aim of the research is to develop a method of prevention of postpartum endometritis in cows using cell-free probiotics "Bacinil" and "Lactimet" with 4 % suspension of aspartic acid. Complex use of integrated cell-free probiotics "Bacinyl" and "Lactimet" with 4% suspension of asparagic acid for the prevention of postpartum endometritis in doses of 7.5 and 10 ml each at 3-fold use once a day for 3 days in a row allowed to obtain 100% preventive effi cacy. The mechanism of action of probiotic "Bacinil" is based on the high activity of components of its composition - immunostimulants (lipopolysaccharides), bacteriocins and enzymes, probiotic "Lactimet" due to biosynthetic lactic acid and a complex of fermentation products. Complex application of probiotics and aspartic acid increases their bacteriostatic activity, which allows more actively suppress the proliferation of pathogenic and opportunistic microfl ora, complicating the fl owing of postpartum endometritis; promotes liquefaction of exudate accumulated in the uterine cavity due to enzymes included in probiotic "Bacinil"; leads to activation of local immunity of endometrial tissues due to immunostimulating activity of components of "Bacinil" and "Lactimet" probiotics; creation of low pH level in the uterine cavity due to aspartic acid and biosynthetic lactic acid.

Introduction: Postpartum endometritis is a prevalent reproductive disorder in bovines, leading to a prolonged open period, infertility, and other complications. While Lactobacillus strains can mitigate these conditions by reducing uterine inflammation, their effectiveness is limited due to a lack of direct anti microbial action and extended treatment duration. This study aimed to construct a recombinant Lactobacillus johnsonii strain expressing bovine Granulocyte-macrophage colony-stimulating factor (GM-CSF) to evaluate its potential in reducing postpartum uterine inflammation., Methods: The recombinant Lactobacillus johnsonii strain was engineered to express bovine GM-CSF and administered to pregnant mice via vaginal perfusion. Postpartum endometritis was induced using E. coli infection, and the protective effects of the engineered strain were assessed. Inflammatory markers (IL-6, IL-1β, TNF-α), myeloperoxidase (MPO) activity, and nitric oxide (NO) concentration were measured. Histological examination was performed to evaluate uterine morphology and pathological damage., Results: The recombinant L. johnsonii strain expressing GM-CSF significantly reduced inflammation levels induced by E. coli infection in the uterus. This reduction was evidenced by decreased expression of IL-6, IL-1β, TNF-α, as well as reduced MPO activity and NO concentration. Histological examination revealed improved uterine morphology and reduced pathological damage in mice treated with the recombinant GM-CSF strain. Crucially, the recombinant strain also exerts beneficial effects on bovine endometritis by reducing levels of inflammatory cytokines, suggesting a beneficial effect on clinical bovine endometritis., Conclusion: The recombinant Lactobacillus johnsonii expressing GM-CSF demonstrated protective effects against postpartum endometritis in bovines by reducing inflammatory cytokines. The findings indicate the potential clinical application of this engineered strain in preventing postpartum uterine inflammation, offering a novel and effective protective option for related disorders and improving bovine reproductive efficiency., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Guo, Cao, Li, Wang, Zhong, Wang, Fan, Zhao, Wang, Fang, Liu, Ding, Ma and Lu.)

We assessed intrauterine bacterial growth for elective and non-elective caesarean sections (CSs). Aerobic uterine cultures were obtained from the uterine cavity immediately following placental removal from 1376 patients who underwent CS in one center during one year. About 13.8% (115/832) of elective CS were positive vs. 55.9% (304/544) of non-elective CS (p <.001). Of non-elective CSs, 28.6% (56/196) of those without ruptured membranes (ROM) were positive vs. 71.3% (248/348) with ROM (p <.001). Mean birth weight and 1-minute Apgar scores were significantly lower in women with positive cultures, elective and non-elective, than negative cultures. A higher percentage of women with positive uterine cultures presented with postpartum endometritis (p <.05). Intrauterine bacteria in elective CSs demonstrate that the uterine cavity is not sterile. Non-elective CS, particularly after membrane rupture, is a significant risk factor for positive uterine culture. Positive uterine culture is associated with lower birth weight, lower one-minute Apgar score and postpartum endometritis. What is already known on this subject? Postpartum endometritis is a leading cause of postpartum febrile morbidity. Caesarean sections, in particular non-elective cesareans, are an important risk factor for the development of postpartum endometritis. Controversy exists concerning the sterility of the placenta and uterus. The diagnosis of endometritis is based mainly on clinical findings and does not necessitate bacterial isolation from the uterine cavity. Positive culture at caesarean section has been associated with positive postoperative culture and yet, currently, professional organisations do not recommend the routine sampling of intrauterine cultures during caesarean section. What do the results of this study add? Since positive uterine culture rate was higher in non-elective CSs and associated with lower birth weight and 1-minute Apgar score and postoperative endometritis, obtaining uterine culture in those cases might be of clinical value. What are the implications of these findings for clinical practice and/or further research? Obtaining routine intrauterine cultures during non-elective caesarean sections might be useful for detecting significant pathogens and tailoring antibiotic treatment in postpartum endometritis. Further studies are necessary in order to determine the impact of obtaining intrauterine cultures during caesarean sections, particularly non-elective cesareans. [ABSTRACT FROM AUTHOR]

Sepsis, associated with Eggerthella lenta is rarely reported, despite current possibilities for microorganisms isolation and identification. About 100 cases of bacteriemia associated with this pathogen have been reported so far. Postpartum infectious complications are mostly associated with bacterial inhabitants of gastrointestinal tract and vagina, including obligatory anaerobes. This case report highlights E. lenta-associated severe endometritis complicated by abdominal sepsis in a young healthy woman, and the challenges of antibacterial therapy. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this work was to study the dynamics of structural manifestations of acute cases of postpartum endometritis in cows. Materials and Methods: The light and electron microscopy methods were used when studying structural changes in the endometrium in case of postpartum endometritis in seven cows. Sections of endometrial specimens for light microscopy, 5-7 μm thick, were stained with hematoxylin and eosin and also by Van Gieson's. For electron microscopy, semi-thin sections were stained with Azur-2 in combination with basic fuchsin, as well as contrasting by lead citrate and uranyl acetate. Results: As a result of the study, we have established the following: Necrobiosis of the epithelial layer of the mucosa, cellular infiltration with shaped elements of blood in the functional layer, swelling of the cells of the uterine gland, and single microbial cells on the surface of the mucosa. We have noted edema of the stroma of the functional layer of the endometrium, swelling of the epithelial layer of the endometrial mucosa, and swelling of fibroblastic and lymphoid cells. Ultrastructural changes in endometrial cells in case of acute postpartum endometritis in cows are accompanied by the destruction of microvilli on the apical surface of the epithelium, an abundance of coccal microflora on the surface of the epithelium, necrobiosis of epithelial cells, and partial edema of the nucleus, and cytoplasm of the histiocyte. Conclusion: We had established that acute purulent-catarrhal dystrophic processes were observed in the structural organization of the endometrium. In the depth of catarrhal mucus on the surface of the endometrium, there was an abundance of bacterial flora, with diplococci being prevalent. In ultrastructural organization of the endometrium, we observed deep dystrophic and necrobiotic processes in the parenchyma and endometrial stroma, as well as exudative processes with a change in the integrity of the microcirculatory bed. Thus, to prevent an inflammatory process from turning into a latent form, it is necessary to detect acute postpartum endometritis promptly using diagnostic methods taking into account the obtained parameters of the dynamics of structural changes in the uterine tissues.

Objectives: Cesarean sections, particularly non-elective cesareans, are an important risk factor for the development of postpartum endometritis, a leading cause of postpartum febrile morbidity. We evaluated the yield of obtaining routine intrauterine culture during elective and non-elective cesarean sections, in the prevention and management of postpartum endometritis.Study Design: A retrospective comparative study investigating the distribution of uterine cultures obtained immediately after fetus and placenta delivery during cesarean sections performed in a single tertiary hospital during 2017. True pathogenic bacteria were included in the study analysis and considered as positive results, while other contaminant bacteria were excluded.Results: Positive uterine cultures were identified in 10.7 % (88/821) of cesarean sections, with no significant difference in prevalence between elective and non-elective cesareans. Escherichia coli (E.coli), isolated in 40.9 % of the positive cultures of all women, was the most common organism in non-elective cesareans vs. Group B Streptococcus (GBS) in elective cesareans. Higher rate of positive cultures was found in term vs. preterm cesareans (17.5 % vs 10.5 %, respectively, p-value = 0.04). E.coli was the most frequent pathogen reported in both women with intact membranes or premature rupture of membranes (46.3 % and 47.3 % respectively). Eight women (9.1 %) with positive cultures presented with postpartum fever; all had undergone non-elective cesarean section. In one-third of these cases the empirical antibiotic treatment was adjusted according to the uterine culture results and susceptibility testing results.Conclusions: Obtaining routine intrauterine cultures during non-elective cesarean sections might be useful for detecting significant pathogens and tailoring the antibiotic treatment in postpartum endometritis. [ABSTRACT FROM AUTHOR]

Puerperium pyoinflammatory diseases (PID) represent the most crucial problem in obstetrics. Among the PID pathologies, the leading place belongs to postpartum endometritis, most commonly occurring after surgical and pathological childbirth. Given the fact that in the pathogenesis of postpartum PID the significant role belongs to changes in the immunological status characterized either by the combined inhibition of T- and B-systems of immunity or, primarily, by damage to T-lymphocytes, the inclusion of immunomodulatory drugs in the complex therapy of postpartum endometritis contributes to a more rapid achievement of clinical effect and allows to obtain favorable outcomes.

Industrial test for comparative evaluation of methods for the treatment of acute endometritis in cows using the wombs beside cortex in combination with endometrium-bio and gamavit carried out on cows of black-motley breed in the Chuvash Republic. For experiments 2 groups of cows 90 animals each were formed: experimental and control, with clinically severe signs of postpartum purulent-catarrhal endometritis acute flow at 3-5 days after birth. In the experimental group of cows endometritis treatment was performed using wombs beside cortex at 11 BAP (№ 17, 18, 22, 30, 31, 32, 33, 34, 29, 50, 51) in combination with antimicrobial drug endometrioma-bio in a dose 150 ml per 1 head, intrauterine, with an interval of 48 hours to recover, and the drug gamavit in a dose of 0.05 ml per 1 kg of animal weight, intramuscularly, with an interval of 48 hours, three times. In the control group uteroton were appointed at a dose of 10 ml per 1 head, intramuscularly, daily, five times, ichglukovit at a dose of 10 ml per 100 kg of live weight, every 48 hours three times, and acidific at a dose of 10 ml per head intramuscularly, with an interval of 3 days, five times. The effectiveness of the treatments showed that the best results were obtained in the experimental group. Recovery was 90%, which is higher compared to the control at 20%, the impregnation rate of the cows higher by 21%, reduced the time duration of infertility at 16.20±4.02 (p

Background: Postpartum infections, also known as puerperal fever, are bacterial infections of the female reproductive tract following childbirth or miscarriage. Symptoms usually include a fever greater than 38.0°C (100.4°F), chills, lower abdominal pain, and possibly bad-smelling vaginal discharge. It usually occurs after the first 24 hours and within the first ten days following delivery, but life-threatening infection may occur within hours of delivery. Cases Report: We reported a case of severe parametritis in the first 24 hours of delivery. Cesarean section is a risk factor for postpartum infections, and response to treatment is lower than vaginal delivery. Our case was a severe pelvic infection after vaginal delivery, and its risk factor was prolonged rupture of the membrane. Therefore, rapid diagnosis and treatment are necessary to prevent abscess formation and sepsis. Conclusion: In this case, rapid treatment with broad-spectrum antibiotics prevented abscess formation, sepsis, and hysterectomy. [ABSTRACT FROM AUTHOR]

Background: Clinical chorioamnionitis complicates approximately 1-4% of pregnancies overall. Although universal agreement does not exist regarding the antibiotic regimen of choice, most studies have evaluated intravenous ampicillin dosed at 2 g every 6 hours plus gentamicin dosed every 8 hours. Only three studies have examined daily gentamicin for the treatment of intrapartum chorioamnionitis and thus is insufficiently investigated. Objective: This study seeks to determine whether daily dosing of gentamicin using ideal body weight for the treatment of intrapartum chorioamnionitis is more or equivalently efficacious when compared to traditional 8-hour dosing regimens. Materials and methods: We conducted a retrospective cohort study and reviewed charts on all women receiving treatment for intrapartum chorioamnionitis, which included intravenous gentamicin daily dosing calculated using 5 mg/kg ideal body weight or receiving traditional every 8 hours dosing of gentamicin at two large academic centers. Our primary outcomes were resolution of infection following delivery without the development of maternal endometritis and/or neonatal sepsis. Baseline characteristics were compared between dosing groups using Welch two-sample t-tests for continuous variables, uncorrected X2 test and exact binomial 95% confidence intervals. We calculated the risk ratios of each outcome in the ideal versus traditional dosing groups using modified Poisson regression, both crude and adjusted. Adjusted models were controlled for variables determined to be potential confounders, which included BMI, diabetes mellitus, gestational blood pressure >140/90, group β-Streptococcus status, race, advanced maternal age (>34 y), and parity. Results: The study included 500 patients with 255 patients receiving daily dosing of gentamicin and 245 receiving traditional dosing of gentamicin. Of the patients receiving daily gentamicin compared to traditional dosing, 95.7% (95% CI 94.9-96.6%) achieved the primary outcome versus 92% (95% CI 90.8 - 93.2%), 2.4% (95% CI 1.8-3%) developed endometritis versus 5.6% (4.5-6.7%), 1.6% (95% CI 1.1-2.1%) delivered neonates with sepsis versus 3.3% (CI 2.5-4.1%), and 36.9% required cesarean delivery versus 41.4%. In crude analysis, compared to traditional dosing, IDW daily dosing was associated with a lower risk of postpartum endometritis (RR 0.42, 95% CI 0.16-1.10, p = .032). After adjusting for BMI, diabetes mellitus, gestational blood pressure >140/90, group β-Streptococcus status, race, advanced maternal age (>34 y), and parity, the IDW daily dosing group had a 5% greater chance of successful outcome (RR 1.05, 95% CI 1.00-1.10, p = .046) and a 64% lower risk of endometritis (RR 0.35, 95% CI 0.15-0.83, p = .017). Conclusion: Daily dosing of gentamicin using ideal body weight is associated with a lower risk of postpartum endometritis and high chance of a successful outcome in the treatment of intrapartum chorioamnionitis compared with traditional 8-hour dosing in our ethnically diverse, urban population and thus may be considered a superior option to every 8 hours dosing regimens. [ABSTRACT FROM AUTHOR]

The objective of the present study was to evaluate the application of some strip test markers (i.e., leukocyte esterase (LE) activity, protein, nitrate and pH) for diagnosis of endometritis in dairy cows using vaginal fornix discharge. Also, the total white blood cell count (t-WBC/l) of this secretion and degenerative changes of neutrophils in cervical cytology were used as alternative methods to predict progression of the endometritis severity. Holstein cows (n=215) between 30-40 days in milk (DIM) were included and examined. Giemsa-stained smear was prepared from cervical mucus. Cervical cytology test was considered as reference screening method for the detection of subclinical endometritis. The LE activity and t-WBC in the vaginal fornix discharge of subclinical endometritis cows were significantly higher than those from healthy cows. Sensitivity and specificity were 78% and 73% for LE10 activity (10 minutes after contacting with discharges) and 60% and 69% for t-WBC (cut off point=210 cells/l) for diagnosis of subclinical endometritis, respectively. There was a good agreement between LE10 activity, t-WBC and cervical cytology test with a Kappa coefficient of 0.4 and 0.42, respectively (P

Objective: to develop a technology for obtaining the molded sorbent VNIITU1, to study its physicochemical and biomedical properties, and to evaluate its efficacy in preventing and treating pyoinflammatory complications in obstetrics.Materials and methods. The molded sorbent VNIITU-1 was designed from the carbon porous material based on nanodispersed carbon by mixing with a vehicle, extruding the mixture, drying the extrudate in an inert atmosphere, thermally treating and activating by steam, followed by washing with distilled water and drying (TU 9398043710698342013). The molded sorbent VNIITU-1 is apyrogenic and nontoxic (Toxicity Study Conclusion No. 1998.013.P dated 14.08.2013; Engineering Testing Assessment No. 12.404 ORTI/2013 dated 26.08.2013), it is destined for single administration, sterile, placed in a removable thread capron mesh container, and used to treat and prevent pyoseptic complications in puerperas at risk for infection, such as acute nonspecific postpartum endometritis. A total of 52 puerperas were examined and treated. They had been divided into 2 groups: a study group (n=37) and a comparison group (n=15). In the study group, the hemosorbent VNIITU1 as a porous carbon applicator was postpartum inserted into the uterine cavity, by concurrently performing traditional antibiotic therapy to prevent infectious complications. The comparison group received only traditional antibiotic therapy. The uterine cavity aspirate was examined for IL1β and IL6 levels, its microbial profile, and microbial growth patterns in culture media. The data were processed using a package of applied STATISTICA6.1 programs and standard mathematical tables in Microsoft Excel. Descriptive and variation statistical methods were applied. The data were presented as Me [low quartilehigh quartile (LQHQ)]; two pre and posttreatment dependent variables were compared using the Wilcoxon and Mann-Whitney tests.Results. The molded carbon sorbent VNIITU1 was found to have pronounced antibacterial activity against S.aureus, P.aeroginosa, K.pneumonia, E.coli and S.agalactiae. Examination of lavages from the surface of the sorbent after its removal from the uterine cavity, by using a transmission electron microscope, revealed castoff epithelial cells, leukocytes, macrophages, and microorganisms, which determines the capacity of the sorbent to eliminate not only soluble toxins, but also microorganisms and disintegrating cell elements. Conclusion. The proposed procedure to postpartum endometritis in puer peras at risk for infection via insertion of the porous carbon applicator VNIITU1 into the uterine cavity is more effective than the traditional approach and it can improve treatment results, by completely eliminating pathogens from the uterus and by reducing the level of local proinflammatory cytokines.

The modern data and actual specificity of postpartum endometritis diagnostics are shown in this literature review, dynamics of C-reactive protein at physiological puerperas and septic complications.

Postpartum endometritis is a common complication of cesarean section, the progression of which often leads to the loss of the uterus and the patient's fertility. We evaluated a detoxification therapy for treating patients with postpartum endometritis using an intrauterine application of a modified molded sorbent containing polyvinylpyrrolidone. A retrospective, controlled study included 124 patients with postpartum endometritis. The study group, n = 63, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial therapy in combination with the intrauterine application of a molded modified sorbent containing polyvinylpyrrolidone (FSMP) for 24 h daily for 5 days. The control group, n = 61, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial treatment only. The uterine cavity was infected by coccal flora (Enterococcus faecalis (26.6%), Staphylococcus spp. (21.3%), E. faecium (14.3%), and Gram-negative Escherichia coli (9.6%). A combination of these microorganisms was present in 40.5% of crops. Antibiotic resistance was detected in 53.6%-68.3% of the cases. In the study group, we observed: a faster and higher decrease in neutrophils (p < 0.05); a lower uterine concentration of pro-inflammatory cytokines: interleukin-1 beta (IL-1β) and tumor necrosis factor α (TNFα) - 4.0 and 3.2 times, respectively, compared with the control group (p < 0.05); and a significant decrease in the uterus volume and cavity (M-echo). Using a newly modified sorbent associated with antibiotic treatment in patients with postpartum endometritis, compared with antibiotics alone, we showed a sharp reduction of inflammatory parameters, residual microorganism growth, and faster uterine volume involution. Moreover, the frequency of hysterectomy decreased by 14.4 times., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)