METROTROMBOFLEBIT

METROTROMBOFLEBIT - inflammation and thrombosis of uterine veins, is a complication of postpartum endometritis. Infectious agents (staphylococci, streptococci, Escherichia coli, etc.), penetrating into the veins of the uterus, affect the venous walls and veins surrounding the veins (periflebit), promote the formation of blood clots in the veins. Sometimes thrombi swell. Possible hematogenous spread of the infection to the veins of the pelvis and other areas of the body.

Clinically, there is a slight increase in body temperature (with the exception of cases of suppuration of blood clots, when the temperature on the background of chills rises to 40-41 ° C), lower abdominal pain, increased heart rate, prolonged bleeding from the genital tract, delayed reverse development of the uterus after childbirth. During vaginal examination, tenderness of the uterus is noted, sometimes on its front surface palpable convoluted cords, which are enlarged veins. In the blood there is a moderate leukocytosis , an increase in ESR.

Complications : thrombophlebitis of the veins of the pelvis, which develops as a result of hematogenous infection. Sometimes, in the pathological process, in addition to the veins of the pelvis, the veins of the lower extremities are involved.

Treatment is carried out in a hospital. Assign bed rest, antibacterial, desensitizing and analgesics, a diet with the exception of acute and salty dishes, cold on the lower abdomen (in the early days of the disease). The introduction of heparin, which is used under the control of the state of coagulability of the blood, is shown. Neodikumarin , fenilin and other anticoagulants of indirect action are prescribed with great caution, mainly with intolerance to heparin, as they pass into the mother's milk and can cause a neonatal impairment of blood coagulability and the development of hemorrhages, bleeding. Anticoagulants in the first days of the postpartum period should be administered under the control of the parameters of the blood coagulation system.

The prognosis with timely initiated and adequate treatment is favorable. Prophylaxis consists in proper management of labor and postpartum period, timely treatment of endometriometritis.