Forecasting of development of healthcare-associated infectons in puerperas

Abstract

Aim. Identification of possible risk factors, assessment of their information value, and compilation of a prognostic table for assessing the risk of healthcare associated infections in puerperas.

Materials and Methods. Experimental and control groups were formed from among the puerperas. The experimental group included 147 women who developed purulent-septic infection within 30 days after delivery. The control group was formed by the mechanical selection of each 50th labor and delivery record for the aforementioned period and included 300 subjects. Possible risk factors were divided into groups: social factors, factors related to the state of woman's health, factors associated with the peculiarities of the pregnancy course, factors associated with the peculiarities of the labor course, factors associated with the postpartum period.

Results. During the study, the following risk factors were identified: unregistered marriage, prenatal hospitalization to the Department of Pathology of Pregnancy for more than 1 bed-day, first labor, uncoordinated contractions, amniotomy, episiotomy, hysterocervicorrhexis, staying in the ward of separate residence in the postpartum period. Based on the sum of the values of prognostic indices, calculated for each risk factor, three prognostic groups were formed: high, average and low risk. Forecasting of the risk for healthcare associated infection development in a patient is carried out by simple arithmetic addition of prognostic indices.

Conclusion. To prevent healthcare associated infections, it is recommended: to carry out bacteriological examination of an afterbirth and prescribing preventive course of antibiotics to puerperas of the high risk group in the postpartum period; to specify that a woman is at high or average risk, if any, in the discharge documentation to inform the Women's Health Department. The information on belonging of the puerperas to a particular risk group can be used by the hospital epidemiologist when carrying out operational and retrospective analysis.

About the authors

A. E. Agarev

Ryazan State Medical University

Author for correspondence.
Email: aleksey.agarev@yandex.ru
ORCID iD: 0000-0003-2277-1255
SPIN-code: 2624-3854

full-time postgraduate student of Epidemiology Department

Russian Federation, Vysokovoltnaya str., 9, 390026, Ryazan

T. D. Zdolnik

Ryazan State Medical University

Email: aleksey.agarev@yandex.ru
ORCID iD: 0000-0002-5721-2544
SPIN-code: 6138-6712

MD, Grand PhD, Associate Professor, Head of Epidemiology Department

Russian Federation, Vysokovoltnaya str., 9, 390026, Ryazan

M. S. Kovalenko

Ryazan State Medical University

Email: aleksey.agarev@yandex.ru
ORCID iD: 0000-0002-2275-5426
SPIN-code: 6681-6123

MD, Grand PhD, Associate Professor of Obstetrics and Gynecology Department with the course of Obstetrics and Gynecology of the Faculty of Continuing Professional Education

Russian Federation, Vysokovoltnaya str., 9, 390026, Ryazan

V. V. Zotov

Ryazan State Medical University

Email: aleksey.agarev@yandex.ru
ORCID iD: 0000-0002-0551-5623
SPIN-code: 6154-0120

Chief Doctor of the "City Maternity Hospital N1"

Russian Federation, Vysokovoltnaya str., 9, 390026, Ryazan

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Copyright (c) 2018 Agarev A.E., Zdolnik T.D., Kovalenko M.S., Zotov V.V.

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