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INVENTION
Patent of the Russian Federation RU2104529
METHOD OF EARLY DIAGNOSTICS OF THE POST-METAL ENDOMETRITIS
The name of the inventor: Stroev EA; Erokhina AA; Tarasov V.N .; Chikin V.G.
The name of the patent holder: Ryazan State Medical University named after P.Pavlov
Address for correspondence:
Date of commencement of the patent: 1996.01.30
The method can be used in medicine, namely, in obstetrics and gynecology. To improve the accuracy of early diagnosis of postpartum endometritis and simplify the diagnostic procedure, the contents of the uterus cavity in the first 24 hours after delivery are taken by the method of aspiration biopsy, in which the activity of the lysosomal DNAase enzyme is examined. With an increase in this indicator, in comparison with the control, postpartum endometritis is diagnosed. Using this method increases the accuracy of diagnosis by 9%.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely obstetrics and gynecology, and can be used for early preclinical diagnosis of postpartum endometritis, one of the purulent-septic post-gestational diseases.
There is a known method for determining the activity of the inflammatory process in chronic bronchitis (SU, Autobiographical notes N 1543345, 28.04.87, G01 N 33/68), when the level of activity of lysosomal ones is determined directly in the inflammation released from the focus (sputum of the patient) Enzymes.
The closest of the analogues is the method for diagnosing postpartum purulent-septic diseases (SU, Autobiographical notes N 1805397, 14.07.90, G 01 N 33/68), in which the goal is achieved by determining, after the day after birth in the serum, acute Phase / a- 1-antitrypsin, seromucoid (and enzymes / alkaline phosphatase, lactate dehydrogenase, a- hydroxybutyrate dehydrogenase), and when they are diagnosed postpartum purulent-septic diseases. The disadvantage of this method is its non-specificity, since an increase in these indicators in the blood serum can be observed in the inflammatory process of any localization that occurs in the post-gestational period and outside it. At the same time, a large number of simultaneously defined indicators require significant material costs and time.
The aim of the invention is to improve the accuracy of early diagnosis of postpartum endometritis and to simplify the diagnostic procedure. The goal is achieved by the method that, 24 hours after the delivery, the activity of the lysosomal DNAase enzyme is examined in the contents of the uterine cavity from the puerpera and the postpartum endometritis is diagnosed when the activity level of this enzyme is increased.
In practice, the method is as follows. At the puerperas, the content of the uterine cavity is taken in the first 24 hours after the delivery by aspiration biopsy using the gynecologic collection of metaaspirates. To determine the activity of DNA-ase, the method of AA Pokrovsky (Pokrovsky AA, Archakov LI, Cytology, 1968, v. 10, No. 11, pp. 1467-72) was used. Early preclinical diagnosis of postpartum endometritis in the puerperas using the proposed method was carried out in 50 women. As a control, we used data obtained from 119 puerperas with the physiological course of the postpartum period. The studies were carried out 1 day after the birth. The reliability of the results of the study, which are necessary for the early preclinical diagnosis of postpartum endometritis, is 98%. The determination of reliability was based on the results of the subsequent clinical course of the postpartum period, the data of echography, and the morphology of metoaspirates.
Example 1 . Stomach's mother, 28 years old. This pregnancy was the 4th, flowing smoothly. Risk factors for the development of postpartum purulent-septic diseases were absent. The first day after delivery, the activity of DNA-ase in the contents of the uterus cavity was determined. The studied index was 71.4 nmol / mg protein per hour; It corresponded to the physiological norm. Follow-up monitoring of the puerpera in the postpartum period did not reveal the pathology of puerperia.
Example 2 . Paternal maternity hospital, 21 years old. Pregnancy 1st, in the anamnesis an indication about the presence of risk factors for postpartum purulent-septic diseases: during pregnancy, there was a threat of interruption, which was the reason for the treatment in the hospital. In the genera, the anhydrous interval was 8 hours. On day 1 after the birth, the DNAase activity in the contents of the uterus cavity was 99.96 nmol / mg protein hour, which did not exceed the upper limit of the norm in uncomplicated postpartum period. Subsequent flow of puerperia was not accompanied by clinically confirmed postpartum diseases, which characterized the absence of risk factors for postpartum endometritis.
Example 3 . Rodilnitsa D-VA, 19 years old. Pregnancy 1, childbirth 1. Among the risk factors for the development of postpartum purulent-septic diseases chronic placental insufficiency, a syndrome of delay in the development of the intrauterine fetus, a long anhydrous interval were noted. Pregnancy ended in a timely spontaneous delivery. On the 1st day after birth, the DNAase activity in the metaaspirate was studied, the level of which reached 364.30 nmol / mg of protein hour. Clinical manifestations of postpartum endometritis were not observed for 1 day. After 3 days, a bright clinical picture of endometritis was registered, the treatment of which required complex anti-inflammatory therapy. The development of endometritis was confirmed by routine methods of investigation.
The proposed method for diagnosing postpartum endometritis showed that out of 50 women with a clinically confirmed disease in 49, more than normality of DNAase activity in metoaspirate was registered in the day after delivery, which was 98%, while the accuracy of the known method for early diagnosis of postnatal purulent- Septic diseases was 89%. Consequently, the use of the proposed method improves the diagnostic accuracy by 9% with respect to the prototype.
CLAIM
The method of early diagnosis of postpartum endometritis, including laboratory analysis of metoaspirata the day after delivery, characterized by the fact that, in order to increase the efficiency of the method due to preclinical diagnosis in the first day after birth, the content of the uterine cavity is determined by the level of DNA-ase and with an increase in this index In comparison with the control, postpartum endometritis is diagnosed.
print version
Date of publication 27.03.2007gg
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