New approaches to the treatment of post-cesarean endometritis
Barinov S.V., Tirskaya Yu.I., Kan N.E., Tyutyunnik V.L., Lazareva O.V., Kadtsyna T.V., Khoroshkin E.A., Blauman E.S., Shkabarnya L.L., Pyanova L.G.
Objective: To enhance treatment outcomes for patients with postpartum endometritis using molded carbon polyvinylpyrrolidone-modified sorbent VNIITU-1 PVP, in conjunction with irrigation of the uterine cavity using antiseptic solutions cavitated by low-frequency ultrasound.
Materials and methods: This retrospective, randomized controlled study included 124 patients with postpartum endometritis. Patients in group A (n=48) received injections of molded carbon polyvinylpyrrolidone-modified sorbent (VNIITU-1 PVP) into the uterine cavity. The patients in group B (n=61) received traditional antibacterial therapy. Patients in group C (n=15) underwent combined irrigation of the uterine cavity with an antiseptic solution cavitated using low-frequency ultrasound, followed by intrauterine administration of the modified sorbent.
Results: A comprehensive approach using the modified sorbent VNIITU-1 PVP resulted in a 5.9-fold reduction in TNF-α levels and a 5.6-fold reduction in IL-1β levels in the endometrial aspirate (p<0.05) in group A, which was more effective than that in group B. In group A, hysterectomy was performed in 1 case compared to 14 cases in group B (χ2 =3.904, p<0.05). In group C, ultrasound results indicated that by the 5th day, the involutional processes of the uterus were more pronounced than those in group A.
Conclusion: Solutions cavitated with low-frequency ultrasound enhanced the contractile ability of the uterus and created optimal conditions for the effective sorption of pathogenic microorganisms, toxins, and their decay products by the modified molded sorbent VNIITU-1 PVP.
Authors' contributions: Barinov S.V. – conception and design of the study; Blauman E.S. – material collection and processing, statistical analysis; Shkabarnya L.L., Khoroshkin E.A. – clinical work; Blauman E.S., Barinov S.V. – drafting of the manuscript; Tirskaya Yu.I. – drafting of the manuscript, editing of the manuscript; Barinov S.V., Lazareva O.V., Pyanova L.G., Kadtsyna T.V., Kan N.E., Tyutyunnik V.L. — data interpretation, editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the Omsk State Medical University, Ministry of Health of the Russian Federation (protocol No. 140, dated October 13, 2021).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Barinov S.V., Tirskaya Yu.I., Kan N.E., Tyutyunnik V.L., Lazareva O.V., Kadtsyna T.V., Khoroshkin E.A., Blauman E.S., Shkabarnya L.L., Pyanova L.G. New approaches to the treatment of post-cesarean endometritis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 52-60 (in Russian)
https://dx.doi.org/10.18565/aig.2024.315
Keywords
postpartum endometritis
molded sorbent
VNIITU-1 PVP
cavitated solutions
hysterectomy
pathogenic microbiota
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Received 06.12.2024
Accepted 29.01.2025
About the Authors
Sergey V. Barinov, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia, 644099, Russia, Omsk, Lenin str., 12, +7(913)633-80-48, barinov_omsk@mail.ru, https://orcid.org/0000-0002-0357-7097Yuliya I. Tirskaya, Dr. Med. Sci., Аssociate Рrofessor, Professor at the Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health
of Russia, 644099, Russia, Omsk, Lenin str., 12, +7(3812)24-06-58, yulia.tirskaya@yandex.ru, https://orcid.org/0000-0001-5365-7119
Natalia E. Kan, Dr. Med. Sci., Professor, Deputy Director of Science – Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, kan-med@mail.ru, https://orcid.org/0000-0001-5087-5946
Victor L. Tyutyunnik, Dr. Med. Sci., Professor, Leading Researcher, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, tioutiounnik@mail.ru, https://orcid.org/0000-0002-5830-5099
Oksana V. Lazareva, PhD, Аssociate Рrofessor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin str., 12, +7(3812)24-06-58, lazow@mail.ru, https://orcid.org/0000-0002-0895-4066
Tatiana V. Kadtsyna, PhD, Аssociate Рrofessor, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin str., 12, +7(3812)24-06-58, tatianavlad@list.ru, https://orcid.org/0000-0002-0348-5985
Ekaterina S. Blauman, PhD student, Department of Obstetrics and Gynecology No. 2, Omsk State Medical University, Ministry of Health of Russia,
644099, Russia, Omsk, Lenin str., 12, +7(908)809-68-78, blauman-es@yandex.ru, https://orcid.org/0000-0002-1498-0578
Egor A. Khoroshkin, Teaching Assistant at the Department of Obstetrics and Gynecology № 2, Omsk State Medical University, +7(3812)24-06-58,
drrussian@mail.ru, https://orcid.org/0000-0002-0433-8960
Lyudmila L. Shkabarnya, Head of the Department of Gynecology of the Perinatal Center, Regional Clinical Hospital, 644012, Russia, Omsk, Berezovaya str., 3/1,
+7(913)966-10-48, l_shka@mail.ru
Lydia G. Pyanova, Dr. Bio. Sci., Associate Professor, Leading Researcher, Laboratory of Synthesis of Functional Carbon Materials, Center for New Chemical Technologies, Institute of Catalysis, Siberian Branch of the Russian Academy of Sciences, 644040, Russia, Omsk, Neftezavodskaya str., 54, +7(3812)67-04-50, medugli@ihcp.ru,
https://orcid.org/0000-0002-6207-0878
Corresponding author: Sergey V. Barinov, barinov_omsk@mail.ru
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