Clinical-laboratory diagnosis of postoperative obstetric-gynaecological peritonitis

Abstract

Aim. To improve early diagnosis of postoperative obstetric and gynecological peritonitis.Material and Methods. This study was conducted among 110 women who developed peritonitis in the postoperative period following primary surgical interventions for obstetric and gynecological pathologies. Comprehensive approaches in clinical and laboratory diagnostics of postoperative obstetric and gynecological peritonitis were applied, including the assessment of hemostasis parameters, endogenous intoxication, acute phase proteins, and cytokines.Results and Discussion. The analysis of the results shows that in the clinical and laboratory parameters, there are relative changes observed in localized peritonitis, and significant shifts in widespread postoperative obstetric and gynecological peritonitis, with and without abdominal sepsis. For instance, in this group of patients, the average values of middle molecular weight molecules were 1674.6±143.5 µg/ml, malondialdehyde - 5.6±0.21 mmol/l. In the group with widespread peritonitis, the level of procalcitonin in the blood was 5.6±0.04 ng/ml, C-reactive protein levels averaged 235.2±0.8 mg/ml, and interleukin-6 levels were 134.5±3.7 ng/ml. In the group with peritonitis without abdominal sepsis, these indicators were lower, being 3.67±0.04 ng/ml, 180.77±18.3 mg/ml, and 112.7±2.1 ng/ml, respectively.Conclusions. The identified pathogenetic changes in homeostasis, particularly the shifts in the levels of procalcitonin, C-reactive protein, and interleukin-6, serve as markers for the early diagnosis of infectious-inflammatory pathologies in the abdominal cavity.