Postpartum Endometritis in Ulaanbaatar City / Монголын Анагаах Ухаан

ABSTRACT

Endometritis is a common complication of the postpartum period. It is still a significant cause of maternal morbidity and, rarely, mortality. The term endometritis basically refers to infection of the endometrium or deciduas with extension into the myometrium. Other terms that have been used to define this infection include metritis, myometritis, endomyometritis, and puerperal sepsis. Involvement of the parametrial tissue is termed parametritis. By foreign researchers, the incidence of endometritis varies significantly depending on the population studied and, more importantly, on the method of delivery, i.e., vaginal vs. cesarean section. The risk of developing endometritis following vaginal delivery is estimated to be between 1 and 3%. But the after cesarean section it occurs about 10-20%. By Sebastian Faro (1990), the bacteria most commonly isolated from the inner uterine surface of patients with acute postpartum endometritis are Streptococcus agalactiae, Streptococcus faecalis, Escherichia coli, Bacteroides bivius and less frequently isolated bacteria are Citrobacter, Acinebacter, and pseudomonas. Objective: To indicate the incidence and cause of postpartum endometritis in Ulaanbaatar city. Design: Retrospective and prospective study. Methods. Collection of history data, abdominal and transvaginal ultrasound study using by Mochida ultrasound apparatus; microbiological study on collected materials from cervix of uterus. Settings. Covered 728 cases whose had diagnosed as postpartum endometritis, which treated in 1st Mternity hospital, 2st Mternity Hospital, 3st Mternity Hospital of Ulaanbaatar city and Mternity Hospital of MCMNC last 3 years (2005, 2006, 2007). Results. Last 3 years, incidence of postpartum endometritis was 1.19% in 1st Maternity Hospital 1.05% in 2st Mternity Hospital, 0.95% in 3st Maternity Hospital of Ulaanbaatar city, 1.51% in Maternity Hospital of MCMNC between all delivered mothers. Postpartum entometritis are obtained 43% between all of postpartum pathologyes. Enterobacter and Staphylococcus aureus are causes each by 13.4% of postpartum endometritis in studied biggest Maternity Hospitals of Ulaanbaatar city. Discussion. Average incidence of postpartum endometritis was 1.17% in Maternity Hospitals of Ulaanbaatar city, last 3 years. It is almost similarity by incidence to foreign researchers study, because this is the risk of developing endometritis following vaginal delivery by them is estimated to be between 3-8% [4]. But in our country the postpartum endometritis after cesarean section was higher than foreign researchers study. The commonly causative bacteria of postpartum endometritis is the E.coli, which causes 73.2% for this disease in studied Maternity Hospitals of Ulaanbaatar city. Conclusions: Last 3 years, by our study the incidence of postpartum endometritis after cesarean section was 29.1%. The Escherichia coli is dominantly inducing for postpartum endometritis with vaginal deliveried mothers, and also with mothers, whose had after cesarean section.