THE FUNCTIONAL STATE OF OVARIES ON THE THIRD-FOUR TH DAY AFTER DELIVERY
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8799Keywords:
physiological postpartum period, ovarian function, colpocytology.Abstract
The aim of the study – to learn the hormonal function of the ovaries in healthy women on the 3rd-4th day after physiological delivery.
Materials and Methods. 100 women with a normal course of the postpartum period were examined by determining the parameters of colpocytological investigations. The control was the data of a survey of 30 healthy non-pregnant women examined in the dynamics of the menstrual cycle. During calculating of epithelial cells in the smear, standard indices were calculated and the background of the smear was taken into account. There were calculated such indices: the index of ripening (RI), сaryopicnotic index (CI), eosinophilic index (EI), fold index and index of crowding. We also took into account the background of the colpocytological smear, namely, the presence of elements that may interfere with the study or indicate a violation of the microecology of the vagina. To such elements we referred leukocytes, cocci, bacillus, erythrocytes, the presence of cytolysis and the background of the smear: slightly turbid, turbid.
Results and Discussion. Analysis of the colpocytogram in healthy women on the 3rd-4th day after delivery showed that in the conditions of a sharp drop in the level of hormones associated with childbirth and the cessation of hormonal activity of the placenta, a new type of vaginal smears appeared, the postpartum-one. By the number of intermediate and superficial cells on the 3rd-4th day after birth, the vaginal smear is most similar to smears in healthy non-pregnant women on the 7th day of the menstrual cycle. Parameters of RI in patients of the main group significantly (p <0.05) differ from the colpocytological findings in healthy nonpregnant women and indicate a low estrogen saturation of the female organism on the 3-4th day after delivery. This type of smears are characterized by the presence of cells of all layers of the vaginal epithelium, which are subject to the the desquamation and destruction during first days of the postpartum period. The percentage indications of the colpocytological indexes which belongs to this type of smears, were within the limits of: RI (3.4 ± 1.8 / 69.0 ± 4.7 / 27.6 ± 4.5), CI (29.7 ± 4.6) and EI (15.7 ± 3.6). Such women are characterized by the prevalence of mild ("+") and moderate ("++") expression of the folding index – 74.5 % and the index of crowding – 71.0 %, which indicates an extremely low level of progesterone saturation of the parturient women in this period.
Conclusions. 1. In the conditions of hormones level decreasing associated with delivery and the cessation of hormonal activity of the placenta, a new type of vaginal smears appears – the postpartum one. 2. This type of smears are characterized by the presence of cells of all layers of the vaginal epithelium, which are subject to the desquamation and destruction during first days of the postpartum period. The percentage indications of the colpocytological indexes which belongs to this type of smears, were within the limits of: RI (3.4 ± 1.8 / 69.0 ± 4.7 / 27.6 ± 4.5), CI (29.7 ± 4.6) and EI (15.7 ± 3.6). 3. Such women are characterized by the prevalence of mild ("+") and moderate ("++") expression of the folding index – 74.5 % and the index of crowding – 71.0%, which indicates an extremely low level of progesterone saturation of the parturient women in this period. 4. The postpartum colpocytological smears are also characterized by: an increased number of leukocytes, a sharp decrease in representatives of normal flora (cocci, bacillus). The obtained results indicate the insecurity of the birth canal of a woman after childbirth and the presence of a high risk of purulent-inflammatory complications during this period. 5. The obtained results indicate the insecurity of the birth canal of a woman after childbirth and the presence of a high risk of purulent-inflammatory complications during this period.
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