The use of platelet autoplasm during cesarean section in pregnant women with a high risk of developing of purulent septic complications

• Zagrat Sh. Mazhidova
• Al’fiya G. Yaschuk
• Il’nur I. Musin

Abstract

Aim – to determine the therapeutic effect of intraoperative administration of platelet autoplasm on the activation of reparative processes of the surgical wound and prevention of the development of purulent-septic complications in pregnant women at risk (gestosis, anemia, signs of intrauterine infection (polyhydramnios, lack of water, fetal growth restriction), who suffered COVID-19 during pregnancy, infections of the genitourinary system resistant to antibiotics, etc.

Material and methods. The study involved 120 pregnant women, whose division into 4 groups was carried out on the basis of the presence of risk factors for the development of purulent-septic complications and the declared methods of treatment: the group 1 – pregnant women without risk factors who underwent a standard cesarean section; the group 2 – similar to the first, but with the use of platelet autoplasm during operative delivery; the group 3 – pregnant women with risk factors for the formation of purulent-septic complications who underwent cesarean section; the group 4 – pregnant women with risk factors for the formation of purulent-septic complications who underwent platelet autoplasm management intraoperatively during operative delivery.

Operative delivery was performed using the Pfannenstiel technique, under spinal anesthesia. Patients of the second and fourth groups were intraoperatively injected with platelet autoplasm. In addition to standard research methods, a laboratory assessment of the syndrome of endogenous intoxication, lipid peroxidation, microcirculation and hemostasis system was introduced.

Results. The use of platelet autoplasm during cesarean section provides a number of advantages compared to standard surgery. Technically, it is a simple and affordable method that significantly reduces the level of blood loss. At the same time, it is important to note that operative delivery with the use of platelet autoplasm lasted 10–12 minutes longer. A number of factors are involved in the development of purulent-septic complications, such as operative delivery during premature birth, preeclampsia, anemia, infections of the genitourinary system that are resistant to antibiotics, prolonged labor, multiple births with an incorrect position of the first fetus, chronic concomitant pathologies. Their presence in pregnant women is characterized by significant disturbances in the homeostasis system in the form of the formation of endogenous intoxication, activation of lipoperioxidation processes, microcirculatory and hemostatic disorders. The introduction of platelet autoplasm during cesarean section surgery was accompanied by a significant decrease in the likelihood of the development of the above pathologies, which, in turn, reduced the incidence of postoperative purulent-septic complications (compared with traditional caesarean section).

Conclusion. The introduction of platelet autoplasm during cesarean section reduces the likelihood of complications in the postoperative period on the one hand, and the frequency of diagnosis of purulent-septic complications on the other.

Keywords:platelet autoplasm; caesarean section; endotoxicosis; lipoperoxidation; purulent-septic complications; microcirculation; hemostasis

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