Experience of using prostaglandin E1 in puerperas with postpartum subinvolution of the uterus

A comprehensive examination and treatment of 61 patients who were hospitalized at the 3 E. V. Klumov City Clinical Hospital in the period from 2020 to 2022 was carried out. All puerperas included in the study were divided into three groups: group 1 (main) – 20 patients (mean age 24.2 ± 2.5), who, along with intramuscular administration of oxytocin, 5 IU with an interval of 12 hours, received PGE1 (mirolute tablets) 200 mcg orally every 12 hours, group 2 (comparison) – 21 patients (mean age 23.7 ± 2.0), receiving standard uterotonic therapy (intramuscular injection of 5 IU of oxytocin 2 times a day for 3–4 days). The control group consisted of 20 women with uncomplicated postpartum period (mean age 23.2 ± 2.1). Procedures of alternating magnetic field (AMF) were carried out for all puerperas on the area of projection of the uterus 1 time per day every day. It has been established that the use of prostaglandin E1 in the conservative treatment of primary uterine subinvolution without signs of an inflammatory process increases its effectiveness by 2.86 times compared with the use of oxytocin alone.

The following criteria for the effectiveness of complex therapy for puerperas were established: a significant decrease in the size of the uterine cavity in comparison with the traditional treatment group by 1.8 times (11.3 ± 0.2 and 6.2 ± 0.2 mm, respectively; p₁ = 0.022). In patients with subinvolution, an inverse pronounced relationship was found between the size of the uterine cavity and the content of oxytocin (r = –0.9784; p = 0.013) and prostaglandin E2 (r = –0.9566; p = 0.015) in the blood serum, which dictates the need prescribing means and methods that increase the contractile properties of the uterus during its subinvolution.

1. Blagodarnyj, G. V. Ocenka effektivnosti i bezopasnosti metodov rodovozbuzhdeniya s primeneniem prostaglandina E1 / G. V. Blagodarnyj, E. V. Mozgovaya // Zhurnal akusherstva i zhenskih boleznej. – 2017. – T. 66, № 1. – S. 9–20.

2. Veres, I. A. Primenenie elektromagnitnoj stimulyacii u rodil'nic s poslerodovoj subinvolyuciej matki / I. A. Veres, O. A. Peresada, V. P. Sokol [et al.] // Medicinskij zhurnal. – 2022. – № 2. – S. 59–66.

3. Veres, I. A. Ustanovlenie faktorov, sposobstvuyushchih zaversheniyu rodov putem operacii kesareva secheniya / I. A. Veres // Medicinskij zhurnal. – 2023. – № 1. – S. 4–14.

4. Veres, I. A. Effektivnost' nemedikamentoznoj profilaktiki poslerodovoj subinvolyucii matki / I. A. Veres, O. A. Peresada, O. L. Ivanishkina-Kudina, A. A. Kulikov, T. V. Znovec, I. L. Shiptenko, M. N. Sokolovskaya // Reproduktiv. zdorov'e. Vost. Evropa. – 2020. – T. 10, № 1. – S. 22–30.

5. Ob utverzhdenii klinicheskogo protokola «Medicinskoe nablyudenie i okazanie medicinskoj pomoshchi zhenshchinam v akusherstve i ginekologii»: postanovlenie M-va zdravoohraneniya Resp. Belarus', 19 fevr. 2018 g., № 17 // Konsul'tantPlyus. Belarus' / OOO «YUrSpektr», Nac. centr pravovoj inform. Resp. Belarus'. – Minsk, 2022.

6. Budden, A. High-dose versus low-dose oxytocin infusion regimens for induction of labour at term / A. Budden, L. Che J, A. Henry // Cochrane Database Syst Rev. – 2014. – № 10.

7. Malm, M. Development and stability of a heat-stable formulation of carbetocin for the prevention if postpartum hemorrhage for use in low and middle-income countries / M. Malm, J. Madsen, J. Kjellstrom [et al.] // Journal of Peptide Science. – 2018. – № 6. – P. e3082.

8. Oladapo, O. T. Intramuscular versus intravenous prophylactic oxytocin for the third stage of labour / O. T. Oladapo // The Cochrane Database of systematic Reviews. – 2018. – № 9(9). – P. CD009332.

9. Salati, J. A. Prophylactic oxytocin for the third stage of labor to prevent postpartum hemorrhage / J. A.Salati, S. J. Leathersich, M. J. Williams [et al.] // The Cochrane Database of systematic Reviews. – 2013. – № 10. – P. CD001808.