The value of cytological examination of mammary gland secretions in the early diagnosis of lactation disorders
One of the most pressing issues of modern obstetrics and neonatology is breastfeeding and the formation of lactation. Breastfeeding is a unique condition of a woman that depends on full lactation. Lactation is a complex process, preparation for which begins from the early stages of pregnancy. Lactation is an integral part of the reproductive period, it is during this period that a number of functions in the body of the maternity hospital are normalized. Lactation disorders are closely related to breastfeeding. In the Russian Federation, more than 10% of mothers do not breastfeed a child from birth. Therefore, early diagnosis of lactation function disorders will allow timely correction of these disorders, which will lead to an increase in the duration of the lactation process. Materials and methods. Secretory mechanisms of lactation formation in maternity women with impaired lactation function have been investigated. The group of examined included maternity patients aged 18-42 years, who had independent urgent labor. Lactation function and the dynamics of secretory activity were evaluated on the 2nd, 3rd and 5th days in the postpartum period. The volume of milk was determined by the correspondence of the amount of secreted mother's milk to the needs of the newborn Results. The conducted studies have shown that in the mechanism of development of lactation disorders in maternity women, certain changes in secretory activity occur. In the women of the control group, the smear was characterized by a significant or moderate amount of medium-sized milk-fat globules. In most cases, milk-fat balls are presented in the form of conglomerates with the inclusion of cells in them. These cells are represented by somatic and lymphoid elements. In smears rich in epithelial cells and leukocytes, most of them were in a state of aggregation. Results. The conducted studies have shown that in the mechanism of development of lactation disorders in maternity women, certain changes in secretory activity occur. In the women of the control group, the smear was characterized by a significant or moderate amount of medium-sized milk-fat globules. In most cases, milk-fat balls are presented in the form of conglomerates with the inclusion of cells in them. These cells are represented by somatic and lymphoid elements. In smears rich in epithelial cells and leukocytes, most of them were in a state of aggregation. Cytological examination of the composition of the secretion of the breast with impaired lactation showed that the smear was poor in milk-fat globules. Subsequently, on the 5th day, there was no increase in milk-fat globules. In the absence of aggregation of leukocytes and sufficient output of leukocytes, the daily volume of milk is 2 times less. The cellular composition of the secretion was meager: rare epithelial and small leukocytes. The lowest indicators of the average daily amount of milk were found in maternity patients with impaired lactation. Conclusions. Cytological studies of mammary gland secretions indicate that lactation disorders are observed in the absence of the phenomenon of leukocyte aggregation.