Otitis

Uteroplacental apoplexy - doctor's tactics. What is Cuveler's uterus? Causes, clinic and treatment methods

Every person from the moment of his birth is surrounded by millions of different microorganisms. Some of them are harmless, even useful, while others, on the contrary, have a negative effect on the body, for example, such as those that can provoke the development of a number of pathologies. However, medicine also knows other pathogenic bacteria, including staphylococcus.

So, what is staphylococcus, what is characteristic of this organism and why is it dangerous for people?

What is staphylococcus? It should be said that a sedentary lifestyle is typical for this gram-positive microorganism.

Staphylococcus(Staphylococcus) has rounded shape, whose diameter is 0.6-1.2 mm, belongs to the staphylococcal family. The main habitat is human mucous tissues and skin. It can be crushed into several layers, in the end it looks like bunches of grapes (in pure culture), a photo of staphylococcus is presented below.

Staphylococcus aureus

What kind of staphylococcus is this? On a nutrient medium of dense consistency it has a purple, white, golden or yellow, and on a liquid one - with uniform turbidity. This microorganism is almost always present on the surface of the human body, but with a decrease in the body’s defenses, it penetrates inside and begins its destructive effect on internal organs and systems human body.

With a strong and normal immune system, it does not create any special problems.

So what is staphylococcus and why is it dangerous for people? It is dangerous because capable of producing toxic substances and enzymes, which have a pathogenic effect on the cells of the human body and lead to their destruction.

Today medicine knows about 27 subspecies of this pathogenic organism, each of them has different aggressiveness and pathogenetic activity.

Methods of infection with bacteria

Staphylococcus bacilli are among the most common pathogens. Can live in oral cavity, on mucous membranes, in respiratory system, in the gastrointestinal tract, urinary system, V intimate organs. In addition, they are present in the air and on all household objects.

Several types of staphylococcus are dangerous to humans, especially:

Saprophytic.
Epidermal.
Hemolytic.
Golden.

Staphylococcal bacilli are transmitted in the following ways:

In addition to direct routes of infection with staphylococcus infection, there are also indirect routes of infection:

Diseases that weaken the human immune system.
Stress, poor sleep.
Hypothermia of the body, as a result - the development of inflammatory processes in the upper respiratory tract, which is favorable for staphylococci.
Diabetes mellitus, endocrine system disorder.
Smoking, alcohol abuse.
AIDS or HIV infection.
The presence of various chronic diseases.
Age. Newborns, preschool children, and the elderly are most susceptible to infection.
Having influenza or ARVI.
Long-term use vasoconstrictor drops, disrupting the integrity of the nasal mucosa, thereby facilitating the penetration of bacteria.
Eating infected foods.
Injuries to mucous membranes or skin areas.
Insufficient hygiene.

What diseases does it provoke?

Saprophytic

Affects mucous membranes most urethra, provoking the development of cystitis in women.

Epidermal

Staphylococcus photo

It has the ability to take root on any areas of the mucous membranes and skin. For healthy person it is practically not dangerous, but for patients in intensive care, once inside their body, it provokes blood poisoning (sepsis) and inflammation inside heart (endocarditis).

Golden

The most dangerous of all types of bacteria, damages all organs, thereby causing the development of more than 100 diseases, including fatal ones, which is also typical for.

Staphylococcus aureus is extremely hardy and tenacious, easily resisted protective properties body.

Withstands high temperatures, not afraid of ultraviolet rays, hydrogen peroxide, 100% ethyl alcohol and some drugs with antibacterial capabilities, in addition, are highly toxic.

Before the development of antibiotics, 9 out of 10 cases of infection with Staphylococcus aureus resulted in fatal outcome. The advent of penicillin contributed to effective fight with this infection. However Staphylococcus aureus very quickly developed immunity to antibiotics; today this microorganism has good resistance to penicillin.

By medical statistics –about 20% of people are carriers of Staphylococcus aureus. The pathogen is transferred from the location of its colonies to an injured area of the skin, or through direct contact with a carrier of staphylococcal infection.

This type of staphylococcus bacteria can lead to the development of serious pathologies:

Particularly dangerous hospital strains staphylococcal bacilli that circulate in hospitals. They are characterized by increased virulence and stable resistance to antibiotics.

Staphylococcus diseases, in most cases, manifest themselves in patients with a weak immune system , for example, in pregnant/lactating women, cancer patients, newborns, and in those patients who were forced to undergo long-term antibacterial treatment.

The symptomatic picture that is characteristic of staphylococcus is determined by what type of microorganism provoked the development of the disease, however, there are also common signs:

Increased body temperature.
Hyperemia.
Swelling of tissues.
Painful discomfort due to compression of nerve endings by edematous tissue.
Disruption of organs and tissues due to the influence of infection on cells.

To determine correct diagnosis and it is very important to determine the type of pathogen.

That's all today bacteriological laboratories accurately determine the specific type of microorganism, its degree of susceptibility to antibiotics and other drugs.

Prevention methods

To avoid infection with staphylococci, follow the rules of personal hygiene, promptly treat caries, manifestations of conjunctivitis, boils, inflammation genitourinary system, strengthen the body, stick to preventive measures in relation to acute respiratory viral infections and acute respiratory infections.

Acne due to Staphylococcus aureus

Do not forget to systematically ventilate the room and do wet cleaning.

During an epidemic respiratory diseases avoid crowds of people, lead an active lifestyle, play sports.

Conclusion

Do not despair if a staphylococcal infection appears in your body. Timely consultation with a doctor and compliance with his recommendations regarding therapy and prevention will help you quickly and effectively recover from the disease.

One of the first places among many pathogenic microorganisms is occupied by staphylococcus: how the infection is transmitted, how to avoid infection - frequently asked questions.

With the active growth of bacteria, pronounced, very characteristic features, which cannot be ignored. Timely treatment will help avoid the development of serious complications.

Staphylococcus - what is it?

Staphylococcus is a gram-positive bacterium in the form of a ball, characterized by low mobility, and forms groups similar to a bunch of grapes. This pathogen belongs to the opportunistic microflora, lives in the nose, pharynx and on skin, is activated against the background of weakened immunity and chronic diseases.

What types of bacteria are most dangerous for humans:

Saprophytic staphylococcus - affects the organs of the genitourinary system, lives on the epithelium of the genital organs, the urinary canal, provokes the development of cystitis and nephritis.
more widespread than the other two brothers and much more dangerous than them. When infected, purulent and inflammatory processes on the skin, in the nasopharynx, heart, blood vessels.
Staphylococcus epidermidis - lives on the skin, can penetrate into the blood through scratches, which will cause inflammation of the lining of the heart, meninges, blood poisoning and so on.

Treatment of infection

The basis of treatment for staphylococcus is antibacterial drugs; they are prescribed after receiving the results of tests for the sensitivity of bacteria to active substances medicines.

Drug groups:

In the treatment of staphylococcal furunculosis, the autohemotransfusion method is used - the patient is injected intramuscularly with his own venous blood; after destruction, the decay products begin to stimulate local immunity. If treatment does not bring desired result, abscesses and boils are opened surgically.

Methicillin-resistant Staphylococcus aureus is resistant to most antibacterial drugs, can only cope with the microbe Linezolid, Fusidine, Vancomycin, they must be taken together with Biseptol.

How not to get infected?

To avoid staphylococcal infections, it is necessary to constantly strengthen the body’s defenses - in children and adults with strong immunity the chance of infection is low.

Prevention of staphylococcal infections:

careful observance hygiene rules– you need to wash your hands as often as possible, try not to touch your face too much, each family member should use their own towel;
even minor scratches must be treated immediately antiseptic drug, cover with adhesive tape or apply a sterile bandage;
eat properly and balanced, refuse junk food, bad habits;
get enough sleep, avoid stress and hypothermia;
move more, take daily walks fresh air, do not forget about hardening procedures;
Ventilate the room more often, regularly carry out wet cleaning of the room;
carry out timely prevention of influenza and ARVI, do not delay the treatment of caries, diseases of the nasopharynx and genitourinary system;
wash vegetables and fruits well, subject meat, fish, eggs to thorough heat treatment, use only purified water;
use condoms.

Since staphylococcus often begins to actively multiply during pregnancy, it is necessary to undergo diagnostics in advance and constantly monitor the number of pathogenic bacteria in the body.

From the video you will learn about common mistakes in the treatment of staphylococcus based on test results:

Staphylococcal infections are dangerous to human life and health, especially for children. Timely diagnosis and correctly selected medications will help to avoid the development of severe complications, and compliance with simple preventive measures reduces the risk of infection or relapse of the disease to a minimum.

Couveler's uterus, also called uteroplacental apoplexy, is a type of pathology that occurs against the background of a weakened placenta and is dangerous due to the development of bleeding, as a result of which blood can enter the cavity of the uterine muscles.

Basic definitions

During pregnancy, a woman may experience various complications and anomalies that can negatively affect the progress of pregnancy and the health of the patient and her child. These include Couveler's uterine syndrome. It was identified by the gynecologist Kuveler, in whose honor the syndrome received this name, in 1911, and the following year it was described in his work.

Uterine placental apoplexy, How characteristic type uterus, is a condition in which the placenta is rejected prematurely. In this case, the deviation is accompanied heavy bleeding With high probability penetration into the carpeted muscle tissue the uterine cavity and the peritoneum.

This complication is dangerous not only for the mother, but also, first of all, for the baby in the womb. The fact is that the placenta plays the role of lungs, and its detachment earlier than expected causes hypoxia, as a result of which the fetus is deprived of oxygen and suffocates. In situations where Kuveler's uterus appears directly during the period of gestation of the embryo before delivery, this can threaten the woman in the situation with disability.

Pathology identified by characteristic symptoms on early stages development, subject to treatment. At the same time, the tactics of pregnancy change. Treatment is prescribed by a doctor taking into account physiological and individual characteristics women in position. Most often, treatment of uteroplacental apoplexy involves keeping the patient under constant observation in a hospital. In this case, doctors will be able to promptly identify abnormalities and provide professional assistance.

Identification of the pathological symptom complex of Kuveler's uterus in the later stages of formation increases the risk of a retroplacental hematoma (extensive). In most cases, under such circumstances, the fetus cannot be saved, and the woman in labor may experience complications due to the large volume lost blood. Treatment in such situations is long-term therapy under the supervision of a physician to eliminate negative consequences.

Disturbances during pregnancy, when uteroplacental apoplexy occurs, occur in 1 case out of 100. Knowing the symptoms of the condition and timely seeking medical help increases the likelihood of saving the fetus and allows you to avoid adverse consequences for a woman and her baby.

Why might a complication occur, and how to recognize it?

At normal development During pregnancy, the placenta maintains its position throughout the entire period of gestation. She begins to be rejected after the actual delivery. If this phenomenon occurs prematurely, there is a risk of hypoxia when the fetus experiences oxygen starvation. The initial causes that constitute the prerequisites for the appearance of pathology are still not fully understood by doctors. At the same time, they identified the main factors that determine the group of predispositions to the development of uteroplacental apoplexy. These include:

addiction to alcohol, drugs, smoking;
hypertension;
diabetes;
toxicosis in the third trimester of pregnancy.

Also included in the list of causes of Cuveler's uterine syndrome is large number previous pregnancies with successful deliveries. According to the data demonstrated by statistics, patients who have given birth multiple times are more likely to suffer from the pathology of premature uterine rejection.

In addition to these reasons, there are other factors that can increase the risk of pathology during pregnancy. This:

premature pregnancy or delivery of a post-term fetus;
injuries from the abdominal area;
interventions by gynecologists (rough manipulations during examination, external rotation of the child during childbirth);
tendency to polyhydramnios;
disruption of the normal functioning and contractions of the uterus.

Symptoms

Couveler's uterus may appear against the background of deteriorating blood flow in the subplacental space, as a result of which the villi connecting the placenta to the uterus begin to function worse. As a result, the connection between the uterus and the placenta weakens, and blood vessels burst, provoking its premature rejection.

The development of Couveler's uterine syndrome may be accompanied by the following symptoms:

severe pain in lumbar region, the nature of which resembles attempts;
anxiety, restlessness;
change in the motor activity of the fetus - its movements become very sharp, which also affects the heart rate;
nausea, urge to vomit;
the appearance of slight bloody uterine discharge;
severe pain between contractions (if the placenta is rejected at initial stage labor activity).

However, the symptoms of placental abruption ahead of time do not always include bleeding. There are situations when hemorrhage occurs through the external organs of the reproductive system, accumulating in the space between the wall of the uterus and the placenta. In this case, Kuveler's uterus can be diagnosed by severe pain that occurs when palpating the abdominal area.

Prevention of pathology

As you know, it is much easier to prevent a disease than to treat it. Therefore, in the case of patients prone to developing uteroplacental apoplexy, the problem can be solved through prevention.

To prevent the occurrence premature detachment placenta and negative consequences deviations, you can refer to the following measures:

comprehensive examination at all stages of pregnancy;
timely treatment diseases of any nature;
when identifying a tendency to develop vascular abnormalities and the appearance of uterine hypertonicity, as well as with placenta previa, restriction of motor activity and sexual activity;
at the first alarming sensations and the presence of the first symptoms of trouble, consult professional medical staff.

The intervention of doctors at the first symptoms of Kuveler's uterus allows one to avoid adverse consequences and save the life of the child and the health of the mother.

Women, unfortunately, often suffer from diseases reproductive system. Moreover, some ailments occur in a normal state, while others can appear only during pregnancy. This article will discuss a pathology called “Cuveler’s uterus.” You will learn what tactics are used to treat it, and also find out the risk factors. It is worth mentioning the causes of Cuveler’s uterus and adding information about the method of prevention.

What kind of pathology is this?

Cuveler's uterus is a pathology that occurs exclusively during pregnancy. More often the disease affects expectant mothers last weeks or during childbirth. The pathology “Cuveler's uterus” received its name because of the scientist who first diagnosed such a disease. His last name is Kuveler.

This term can be heard quite rarely from doctors and expectant mothers. More often, Cuveler’s uterus has the colloquial name “premature placental abruption.”

Methods for diagnosing pathology

There are several ways to determine pathology. Cuveler's uterus is a disease that is diagnosed using indirect and obvious signs. Let's look at them in detail.

Clinical picture

As the disease develops, a woman develops bright severe symptoms. The expectant mother experiences strong unbearable pain, which are localized in the lower abdomen and spread to the lower back. On manual examination, the uterus is very painful.

If the pathology develops during childbirth, then she complains of the feeling of one endless contraction. The intervals during which a woman in labor should rest are filled with pain in the lower abdomen.

Besides pain a woman may experience a decrease in blood pressure, perspiration, and nausea with uncontrollable vomiting. There are also abundant spotting from the genital tract, but they may not exist.

Fetal condition

If there is a suspicion of a pathology such as Cuveler's uterus, obstetrics recommends a CTG study. During diagnosis, gynecologists and obstetricians note strong changes V heart rate baby. This happens due to the fact that the detached placenta stops supplying oxygen and nutrients embryo. Oxygen starvation occurs, which doctors call hypoxia.

It is worth noting that this condition is quite dangerous, since during the restriction of oxygen supply, the fetal brain can be severely damaged. In some situations, the death of the embryo is possible.

Purely subjectively, a woman can note that future baby, located in the womb, behaves unusually. The fetus begins to show severe anxiety and hanging motor activity. In some cases, the opposite reaction occurs: the baby becomes quiet and practically stops moving.

Ultrasound diagnostics

Cuveler's uterus is most accurately determined by ultrasound. During diagnosis, the specialist notes thickening of one of the walls of the uterus. Also, between the placenta and the genital organ, which has a rather impressive volume.

Ultrasound (when examined with Doppler) reveals a violation of the blood flow between the fetus and the placenta, and damaged vessels are also visible.

Cuveler's uterus: therapeutic tactics

Women who have developed such a pathology must receive emergency medical care. Otherwise, everything could end quite badly. Some pregnant women lose their babies during this complication, others may remain disabled for life. Prolonged inactivity can result in death.

The treatment strategy for placental abruption is always surgical. The woman undergoes an emergency caesarean section. It is worth noting that this method is chosen even when the baby is already dead.

After removing the fetus from the reproductive organ, the doctor notes the complexity of the pathology. In some cases, it is possible to stop the bleeding and save the uterus. With more difficult situations it is necessary to remove the organ completely (along with the cervix). Cervical canal during surgery they are removed to prevent the formation of blood clots later. Very rarely, it may be necessary to remove appendages from a woman’s pelvis with a pathology called “Cuveler’s uterus.”

The prognosis after surgery depends entirely on the complexity of the pathology. If a woman has retained her reproductive organ, then inpatient treatment. Medicines are prescribed to stop bleeding. When a reverse action is prescribed. In this case, the woman receives which prevent thrombosis.

With fullness and appendages, a woman requires long-term therapy, which is subsequently replaced by lifelong use of hormonal drugs.

Cuveler's uterus: risk factors

Is it possible to find out who is more susceptible to this pathology? Absolutely yes. There is a group certain factors risk. If you find at least one of them, then you should be more attentive to your own condition, and also inform the doctor managing the pregnancy about this. So, what are the risk factors for developing a pathology called “Cuveler’s uterus”?

Diseases of the uterus. If a woman in the past had strong inflammatory diseases pelvic organs, problems may arise with the attachment of the placenta. Also, some diseases can cause premature detachment of the child's place. These include endometritis, endometriosis, adenomyosis and others.
Features of pregnancy. In multiple pregnancies, Cuveler's uterus occurs more often than in normal pregnancies. Also, frequent births in the past (more than five) can cause abnormalities in the placenta.
Bad habits of the expectant mother. If a pregnant woman smokes, drinks alcohol or narcotic drugs, then the placenta ages quickly. Having reached a certain point of development, it simply begins to peel off.
Gestosis, or late toxicosis. If the expectant mother has health problems (kidney pathology, edema, high blood pressure and others), that is, the risk of Cuveler’s uterus.
Abnormalities of placenta attachment. If a pathology such as breech presentation is discovered during pregnancy, then there is a high risk of developing abruption. Also, the placenta located in the front is more likely to have developmental anomalies than the placenta located on the rear wall.

Preventive measures

When registering and throughout pregnancy, a woman undergoes numerous examinations. These include blood and urine tests, diagnosis of the condition of the genitourinary system, examination by a therapist and cardiologist. If any risk factor is detected, it is necessary to carry out prophylaxis in the last trimester of pregnancy and during birth period. There are several ways to prevent the development pathological process. Let's look at them in detail.

Limiting physical activity

For expectant mothers who have problems with cardiovascular system, as well as those who have placenta previa, should completely limit physical activity. Otherwise, sudden force may cause vascular damage and a hematoma may appear between the uterus and placenta.

If bleeding occurs during pregnancy, which is caused by placenta previa or low position of the placenta, then you should be especially careful about yourself. Your doctor may recommend that you listen to the advice of a specialist.

Taking certain medications

If you have health problems, then you should focus your efforts on eliminating them. For example, if you have a disease of the genitourinary system, you should take diuretics and anti-inflammatory drugs. Also during promotion blood pressure you need to take pills that regulate blood flow.

If you experience swelling, consult a doctor. The doctor will prescribe you the appropriate medications. Remember that you cannot carry out treatment on your own. Taking any medications must be coordinated with a gynecologist. Otherwise, you can harm the unborn baby more than help.

On later pregnancy the doctor will prescribe you special means, which improve blood circulation between the fetus, placenta and mother. Most often, this treatment is carried out in a hospital. Do not refuse such a correction. It will always be useful to the future baby.

Maintaining sexual rest

In case of possible placental abruption and the occurrence of Cuveler's uterus, it is recommended to completely limit sexual intercourse in the second and third trimester of pregnancy.

During sexual intercourse, increased contraction of the uterus occurs, which can stimulate the separation of the placenta from the wall of the reproductive organ.

Fetal monitoring

In the later stages of pregnancy (before and during childbirth), it is necessary to monitor the behavior of the unborn baby. It is necessary to examine at short intervals expectant mother using CTG. If there is a suspicion of deterioration in the condition of the fetus, it is necessary to carry out diagnosis using ultrasound.

An ultrasound should be performed a few weeks before the planned birth. During the examination, great attention should be paid to the condition of the placenta. The specialist determines the degree of maturity of this body and draws the appropriate conclusion.

Timely treatment of diseases

The main prevention of Cuveler's uterus is timely treatment of emerging pathologies. So, upon or appearance hormonal diseases it is necessary to begin the appropriate correction in time.

Also, if complaints arise during pregnancy, you should carefully examine expectant mother and, if necessary, prescribe treatment.

Conclusion

So, now you know what Cuveler’s uterus is. Photos of ultrasound pathology are presented in this article. If it occurs, it is necessary to carry out surgery. Only in this case is there a possibility of a positive outcome.

Carefully monitor your health during pregnancy. If symptoms of pathology appear, consult a doctor or call ambulance. Health to you and your baby!

Placenta - most important organ for a person in embryonic period development. During pregnancy, it nourishes the fetus, ensures its respiration and removal of metabolic products. The placenta functions until birth, and only then detaches from the wall of the uterus. If this happens earlier, the most dangerous syndrome for mother and baby develops - Kuveler's uterus.

The name of the pathology comes from the name of the French gynecologist A. Couveler, who was the first to describe the detachment of a normally located placenta in 1912. Couveler's uterus develops in 0.5 - 1.5% of pregnant women and is the most common cause maternal mortality.

Uteroplacental apoplexy

Premature placental abruption triggers the mechanism of Couveler syndrome. Massive bleeding begins, and a large retroplacental hematoma forms between the placenta and the uterine wall. Blood enters muscularis propria organ, permeating it through and pouring into the abdominal cavity.

The detached placenta can no longer perform its functions, which leads to rapidly developing hypoxia ( oxygen starvation) fruit. If more than a third of the placenta detaches, the fetus dies.

The classic Cuveler uterus is a bluish, blood-soaked organ that is unable to contract.

Symptoms of Cuveler's uterus

Quite often, uteroplacental apoplexy develops against the background of a successful pregnancy. In the later stages, pain suddenly appears, which continues to increase, the placenta exfoliates and Kuveler’s uterus forms.

Symptoms of pathology on the part of the mother:

increasing lower back pain;
sharp pain in the abdomen;
nausea;
anxiety and fear;
discharge of blood from the vagina;
signs accompanying acute internal bleeding;
rupture of the membranes;
acute renal and liver failure;
cerebrovascular accident;
coma;

on the part of the fetus experiencing oxygen starvation:

sudden sharp movements, soon slowing down and disappearing completely;
weakening, change in the frequency and quality of the heartbeat.

External bleeding is the most important diagnostic sign Kuveler's syndrome, but it does not always happen. Pain on palpation of the uterus is indicative. There is hypertonicity, muscle hardness, and it is impossible to palpate the fetus. In addition, the changed pattern of fetal movement should alert you: sharp, convulsive, gradually fading jerks indicate hypoxia.

The woman’s condition is rapidly deteriorating and immediate qualified medical attention is required. surgical care. In this situation, minutes can count.

Causes of placental abruption and risk factors

The true cause of Couveler's syndrome is unknown; perhaps it is a manifestation of some hidden systemic pathologies. It all starts with structural changes in the placental vessels, microthrombosis and microembolism in them. Due to a violation of the outflow of venous blood, the vessels rupture and hematomas form. Merging with each other, they form a retroplacental hematoma, which exfoliates the placenta.

There are some signs indicating the possibility of uteroplacental eclampsia in late pregnancy and during childbirth.

Risk factors:

multiple pregnancy;
a large number of pregnancies and births in the past;
mother's age over 35 years;
abnormal attachment of the placenta;
gestosis and preeclampsia in later stages;
maternal hypertension, heart disease;
renal and liver failure, pyelonephritis;
diabetes mellitus;
endocrine disorders, hypothyroidism;
smoking, drinking alcoholic drinks And narcotic substances during pregnancy;
stressful effects;
spicy viral infections during pregnancy;
discoordinated labor activity, complicated delivery.

Prevention and treatment

Kuveler's uterus is an extremely severe symptom complex, the development of which requires the use of urgent measures to save the life of the mother and baby. Immediate surgical intervention is indicated and artificial birth by caesarean section. If indicated, the uterus is removed.

If there is a history of risk factors for uteroplacental eclampsia, it is necessary to especially carefully monitor the progress of pregnancy and carry out preventive measures. Already when registering a pregnant woman with antenatal clinic The attending physician assesses the likelihood of pathology. Based on this, pregnancy management tactics are formed.

If a diagnosis of preeclampsia or late gestosis is established, special attention is paid to the prevention of fetal hypoxia.

It is important to promptly and completely treat inflammatory diseases of the reproductive system, as they can cause pathology of the placenta.

Kuveler syndrome is a serious complication of pregnancy that threatens the life of the mother and the unborn child. The pathology requires urgent and qualified treatment.