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Local electrochemical detoxication and immunomodulation in prophylaxis and treatment of puerperal endometritis


Author: Dorina Muntean
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2006
Scientific adviser: Ludmila Eţco
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Scientific consultant: Iurie Roşcin
doctor habilitat, professor
Institution:
Scientific council:

Status

The thesis was presented on the 13 December, 2005
Approved by NCAA on the 23 February, 2006

Abstract

Adobe PDF document – 0.19 Mb / in romanian

Keywords

postpartum endometritis, puerperal endometritis, puerperal infection, woman recently confined, acute endometritis, postpartum period, postpartum endometrium, immune regulation, immunoregulation, immune deficiency, immunostimulating drug, electrochemical detoxication, hypochlorite sodium, postpartum antibiotic prophylaxis, irrigation uterine cavity

Summary

There are controversial data regarding prophylaxis and treatment of puerperal endometritis in the literature of speciality. Some researchers recommend in the sense herein following of medicamentous-curative regime (antibiotics, sulphanilamide, antiseptics etc.) under protection of antiseptics’ local application and physiotherapy. Other are adepts of untraditional methods with avoidans of antibiotics on the principle that basic requirement to preparation taken in the period of confinement are as follows: major efficiency, complex action, minimal adverse reactions over mother and fetus.

The main problem actual study has based on was study of efficiency of the complex, untraditional method of prophylaxis and treatment of puerperal endometritis. Studding modern particularities of evolution of complication, we designed a new method of prophylaxis and treatment of puerperal endometritis by means of local electrochemical detoxification and immunomodulation with a complex etiopatogenetic action.

The content of the method is on the post-partum second and third day, an uterine cavity smear is made with a solution of sodium hypochlorite in a volume of 400–500 ml and concentration of 600– 700 ml/l, cooled under temperature of 4–5ºC. Simultaneously, 1,0 ml–0,005% Imunofan solution is administered intramuscularly once per day from the first confinement day during 5 days.

Analysis of clinical and para-clinical results has shown a high efficiency of the new method.

Local and systemic immunity indexes evaluation has emphasized that proposed method predominantly affects local immunity through marked out activation of phagocytary system and stimulation of production of lymphoblasts that allowed increment by more than 2,5 times of IgAs. The efficiency of local electrochemical detoxification and immunomodulation has been proved as well by decrement by more than 3 of degree of genital ducts colonization with microorganisms pathogenic or conditionally pathogenic, that has contributed to restoration of vaginal microbiocenosis and fast revival of local immune ecosystem of those confinements.

Raised activity of phagocytary system has induced the elimination of intracellular viral infection.

Correlative study of reparative processes at the endometrial level has proved high net efficiency of the complex method of local electrochemical detoxification and immunomodulation as compared with traditional one. A fast regeneration of endometrium has been emphasized under action of proposed method by marked out migration of young lymphoblast and phagocytary cells at the endometrial level determining endometrium premature regeneration. The method presents no adverse reaction, simple in utilization, and might be applied at any level of perinatal assistance.